The effect of thiphenamil HCI on the urodynamic parameters of bladder filling, voiding and isometric contraction was examined in controls. Data were obtained from 25 control female subjects with a mean age of 27.6 ± 6.6 years. Three urodynamic studies were done on each subject on 3 different days. These studies were: (1) control study, (2) drug study with a single oral dose of 400 mg thiphenamil HCI and (3) another with 800 mg. Each urodynamic study involved filling and voiding cystometrograms to characterize stability, sensations of fullness and urgency, bladder capacity, urethral opening pressure, maximum flow rate, maximum detrusor pressure and residual urine. In addition, isometric detrusor pressure measurements were made at bladder volume increments of 100 ml. Each urodynamic study was done in the sitting position using medium fill water cystometry at 20 ml/min. Isometric pressures were made by catheterizing the subject with an 18-french three-way Foley catheter with a 30-ml balloon. One lumen was used to fill the bladder and the second to measure pressure. The results show that bladder capacity and the volume at which sensations of fullness and urgency are expressed are not significantly changed under the influence of thiphenamil HCI. Significant differences were seen in the maximum pressure generated by the detrusor during voiding and in the maximum urine flow rate. These differences were most pronounced at the 800-mg thiphenamil HCI dose. The isometric data show a highly significant increase in the maximum isometric pressure developed at the low bladder volumes. In the 4 subjects investigated with detrusor instability, 3 had a suppression of spontaneous activity during filling and an increase in bladder capacity from 398 to 499 ml. In addition, the maximum voiding pressure increased from 44 to 55 cm H2O. A significant reduction in posterior urethral closure pressures from 105 ± 23 to 78 ± 24 cm H2O, 0.02 < p < 0.05 was obtained with thiphenamil. It is concluded that thiphenamil HCI has a significant effect on the bladder and urethra of normal asymptomatic controls.

Keywords:
Urodynamics, Bladder, Isometrics, Continence, Stability
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© 1992 S. Karger AG, Basel
1992
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