OBJECTIVES: This study was designed to evaluate bethanechol's efficacy in urinary difficulty, constipation, dry mouth and blurred vision and to evaluate the bethanechol's effect on psychopathology. METHODS: Thirty-two schizophrenic patients who have been treated with antipsychotics and the total score of anticholinergic side effect of 'Rating scale for side effect (no symptom ; 0, severe ; 3)' is above 5 were assigned to three group(controlled group, bethanechol 30 mg/day group, 60 mg/day group). These patients were entered on 6 weeks open trial. Anticholinergic side effects were assessed by 'Rating scale for side effect' and psychopathology by BPRS at base, 2nd week & 4th week. After 4weeks administration of bethanechol, 30 mg/day group was increase to 60 mg/day and 60 mg/day group was decreased to 30 mg/day for 2 weeks for evaluation of dose difference. And then anticholinergic side effects were reassessed at 6th week. RESULTS: There were significant correlations between blurred vision and age. There were no significant improvement of anticholinergic side effect in placebo group but significant improvement of urinary difficulty and dry mouth in 30 mg/day group and significant improvement of urinary difficulty, constipation and dry mouth in 60 mg/day group at 4th week evaluation. In the case dose up(bethanechol 30 mg/day to 60 mg/day) for 2 weeks, dry mouth was more improved. In the case of dose down (60 mg/day to 30 mg/day), the improvements of urinary difficulty and dry mouth were sustained but constipation was aggravated. There were no BPRS changes by bethanechol administration. CONCLUSION: These findings suggest that more than 30 mg/day of bethanechol made improvements in urinary difficulty, constipation, dry mouth, when the total score of Anticholinergic side effect of 'Rating scale for side effect (no symptom ; 0, severe ; 3)' is above 5, although 60 mg/day of bethanechol was more effective than 30 mg/day. Moreover bethanechol administration does not influence psychopathology.
Antipsychotic Agents* ; Bethanechol* ; Constipation ; Humans ; Mouth ; Psychopathology

Background: Postoperative urinary retention is a commonly encountered problem after anal surgery particularly under spinal anesthesia. Bethanchol chloride, a muscarinic cholinergic receptor agonist was used to determine whether it could prevent this problem. Methods: One hundred six patients with mean age of 37+ 9 who underwent anal surgery under spinal anesthesia from January to August 2007 were included in this nonblinded randomized prospective experimental study. Forty- six patients were given bethanechol chloride 25mg/tab 1 hour post- op then another dose after 4-6 hours. Those with the urge to void but unable to do so within the hour or had hypogastric pain (VAS > 8) were immediately catheterized and the amount drain recorded. Conclusion: Although bethanechol chloride did not completely prevent the development of postoperative urinary retention, it use was associated with reduced need for the catheterization.
Human ; Adult ; BETHANECHOL ; URINARY RETENTION ; ANESTHESIA, SPINAL

PURPOSE: In a previous study increasing the extracellular clacium concentration enhanced the phasic contractile response to low frequency stimulation(2Hz) to a significantly greater degree than the enhancement of high frequency stimulation(16Hz). To investigate the sensitivity of the detrusor contractile responses to field stimulation, bethanechol and ATP in calcium free buffer, the current study was designed. MATERIALS AND METHODS: Each rabbit bladder strip of 5x10mm in size was incubated for 30 minutes in the Tyrode's solution. Individual strips were utilized to generate the response to field stimulation(2, 8 and 32Hz), bethanechol(1.0-250microM) or ATP(0.25-2mM). Upon completion of the first stimulation in Tyrode's solution, each tissue was washed 3 1.tomes at 15 minute intervals with fresh Tyrodes. At 15 minutes following the last wash, the Tyrode's solution was replaced with solution containing no calcium+1.0mM EGTA and incubated for ditional 5, 15 or 30 minutes. At the end of 5, 15 or 30-min period of tulibration a second round of field stimulation or dose-response curves to bethanechol or ATP were generated. The contractile responses were monitored via an FT03 force transducer and recorded on a Grass 7D polygraph and expressed as the g tension per 100mg of tissue. RESULTS: (1) Progressive decrease in both basal tension and spontaneous contractile activity (2) more rapid decrease in the contractile response to 2 and 8Hz field stimulation than to 32Hz stimulation (3) more rapid decrease in the contractile response to lower concentrations of bethanechol and ATP than to high concentrations (4) greater maximal inhibition of the contractile response to low concentrations of bethanechol and ATP than to high concentrations. CONCLUSIONS: These results indicated that detrusor contractility to a sub-maximal stimulation rather than maximal stimulation is more sensitive to extracellular calcium depletion.
Adenosine Triphosphate* ; Bethanechol* ; Calcium* ; Egtazic Acid ; Poaceae ; Transducers ; Urinary Bladder*

VUR is usually diagnosed by standard voiding cystourethrography(VCU). However, we are sometimes puzzled not being able to find VUR on VCU in the group of patients in whom VUR is highly suspected from accompanying obvious clinical, urographic and endoscopic features. For the purpose of detecting this type of VUR or 'subclinical VUR, VCU was performed after subcutaneous injection of bethanechol chloride in 3 patients who were highly suspected of VUR and two were diagnosed as subclinical VUR . Case 1 was diagnosed left VUR(grade II ) and case 2 was diagnosed right VUR(grade II) on VCU after' subcutaneous injection of bethanechol chloride. Both underwent unilateral ureteroneocystostomy and are on follow-up. Bethanechol chloride induced voiding cystourethrography is suggested to be a highly method to detect subclinical vesicoureteral reflux.
Bethanechol* ; Follow-Up Studies ; Humans ; Injections, Subcutaneous ; Vesico-Ureteral Reflux*

Pharmacologic treatment of the detrusor hypocontractility(hyporeflexia) remains controversial issues. Clean intermittent self catheterization(CIC) alone, or combination with bethanechol chloride has been generally accepted as treatment modality. Until presently, bethanechol chloride is the only pharmacologic agent commonly used for bladder emptying without significant complication. However, the effectiveness of bethanechol seem to be episodic. The present study compared the contractile response of various pharmacologic agents including bethanechol chloride, ATP, PG E1, E2, F2-alpha on the smooth muscle strips of male rabbit bladder. In addition, effect of the gastrointestinal motility agents such as cisapride and metoclopramide on the contraction of rabbit bladder were assessed. Each bladder was divided into bladder body and bladder base for comparison of pharmacologic effects. FS at basal tension elicited a frequency dependent contraction which was greater in bladder body strips than in bladder base strips. The contractile responses to bethanechol, ATP, PG E1, E2 and PG F2-alpha were greater in bladder body than in bladder base.In the bladder body,magnitude of the contractile responses by ATP and PG F2-alpha were approximately 1/3 of those by bethanechol or FS.PG F2-alpha was consistently more potent to produce contraction than PG E1, E2. ATP induced contraction only consisted of initial phasic rise of tension. The contraction induced by PG developed slower than those caused by bethanechol. Cisapride(10uM) induced weak contractile responses comparable to those by PG E1 Metoclopramide had no contractile effects in this studies. Conclusively, differences exist in the response of the bladder body and base to FS and various pharmacologic agents. ATP, PG E2 and PG F2-alpha exhibited some notable contractile responses to the bladder body that were approximately 1/3 of those by bethanechol. Gastrointestinal motility agents were not shown to be effective in the mediation of contraction of rabbit bladder.
Adenosine Triphosphate ; Bethanechol ; Cisapride ; Gastrointestinal Motility ; Humans ; Male ; Metoclopramide ; Muscle, Smooth* ; Negotiating ; Urinary Bladder*

PURPOSE: The contraction of the bladder is biphasic in nature consisting of an initial phasic contraction followed by a prolonged tonic contraction that is responsible for evacuating the bladder. Previous study demonstrated that the relief of bladder outlet obstruction induced recovery of the ability to initiate contraction, but emptying ability was not recovered within a certain period of time. This study was designed to determine the ability of recovery in tonic contraction and changes of contraction to pharmacologic stimulation through longterm evaluation after relief of obstruction. MATERIALS AND METHODS: Forty eight female rats were used in this investigation. Normal bladder was used as control and experimental groups were classified into 6 weeks obstruction group and 3, 6, 9, 12 weeks groups after relief of obstruction. The phasic and tonic contractile response to field stimulation(2, 4, 8, 16, 32Hz) and the response to bethanechol(3x10-5M), ATP(1mM) and KCl(120mM) were estimated by polygraph. RESULTS: The weight of bladder increased in obstruction group and gradually decreased after relief of obstruction. The phasic and tonic contractile response to all frequency of stimulation were decreased in obstruction group and recovered after relief of obstruction. In low frequency of stimulation, the ratio of tonic to phasic contractile response was decreased in obstruction group and recovered from 9 weeks after relief of obstruction. The contractile response to bethanechol was decreased in obstruction group and rapidly recovered after relief of obstruction. However, there were no change in contractile response to ATP in all group. The contractile response to KCl was decreased in obstruction group, but there were no change after relief of obstruction. CONCLUIONS: These results indicate that the emptying ability is recovered slowly but not enough and the contractile response to cholinergic stimulation is rapidly recovered after relief of obstruction. Further study will be needed for response to ATP and KCl.
Adenosine Triphosphate ; Animals ; Bethanechol ; Female ; Humans ; Rats* ; Urinary Bladder ; Urinary Bladder Neck Obstruction*

Bethanechol promotes bladder emptying by acting on postganglionic parasympathetic effector cells within detrusor muscle to elicit a contraction and is widely used to enhance bladder emptying for incomplete lower motor neuron lesion, idiopathic hypotonic bladder end postoperative urinary retention. However its effects on bladder outlet is inconclusive. Therefore, in vitro study for the effects of bethanechol on the muscle strip from the rabbit bladder neck were undertaken. Ten male white rabbit bladders were divided into body, base and neck and contractile responses of three strips were done. Bethanechol chloride produces most potent contractile response on the bladder body and comparatively less on the bladder base and bladder neck in a dose-dependant manner. Maximal contractile pressures of bladder body and bladder neck were 6.29+/-0.72 and l.22+/-0.53gm tension respectively. Norepinephrine produce maximal contractile responses of 2.09+/-0.49gm tension on bladder body. 1.15+/-0.39 on bladder base and 2.6+/-0.55 on bladder neck. Contractile response or the bladder neck to bethanechol was 50% of those to norepinephrine. These results indicated that bethanechol produce contractile response on the rabbit bladder neck in some degree but weaker than those by norepinephrine.
Bethanechol* ; Humans ; Male ; Motor Neurons ; Neck* ; Norepinephrine ; Urinary Bladder* ; Urinary Retention

PURPOSE: This study was performed to identify the effects of bethanechol, pyridostigmine and levosulpiride, on the contraction of rabbit bladder strip tissue in a single agent administration, and to investigate the synergistic effects in a mixed administration. MATERIALS AND METHODS: Smooth muscle strips of bladder were prepared using female, New Zealand white, rabbits. After an equilibration period, dose response curves to each agent, with cumulative administration, were performed in the basal tension state of the strips. Each strip was then pretreated with the agent at the maximal concentration that would not induce a bladder contraction, and second dose-response curves for the other agents were obtained. Following this, the maximal stimulation with bethanechol was performed, and during the tonic response, pyridostigmine or levosulpiride was administrated to observe any synergistic effects of the agents. Similar experiments were repeated for the pyridostigmine and levosulpiride. RESULTS: Each agent elicited a dose-dependent contractile response, in the order; bethanechol (0-4.49g/100mg tissue), pyridostigmine (0-1.58g/100mg tissue) and levosulpiride (0-0.44g/100mg tissue). In the presence of pyridostigmine (3x10(-6)M) or levosulpiride (10(-4)M), no additive effects were noted after the cumulative stimulation with bethanechol (10(-10)-10(-4)M). During the tonic response of bethanechol (10(-4)M) or pyridostigmine (10(-2)M), the addition of levosulpiride (10(-2)M) induced a significant increase in the bladder strip contractions, but the addition of pyridostigmine (10(-2)M) or bethanechol (10(-4)M) decreased the maximal response (p<0.05). CONCLUSIONS: These results imply that pyridostigmine may be useful for impaired detrusor contractility management. Synergistic effects can also be expected when administrating levosulpiride, in addition to bethanechol, in improving bladder contractility.
Bethanechol ; Female ; Humans ; Muscle, Smooth ; New Zealand ; Pyridostigmine Bromide* ; Rabbits ; Urinary Bladder*

Contraction of the bladder can be divided into two phases. The initial phase (phasic contraction) is characterized by a rapid increase in pressure that results in a change of bladder shape. This phase is followed immediately by a plateau phase (tonic contraction) that maintains an increase in intravesical pressure that is responsible for evacuating the bladder. This study was designed to determine the effect of relief of bladder outlet obstruction on the phasic and tonic detrusor contractile response to field and pharmacologic stimulation in rat urinary bladder. Forty female rats were used in this investigation. Normal bladder was used as control(n=8) and experimental groups (n=32) were classified into 6 weeks obstruction group and 2, 4, and 6 weeks groups after relief of obstruction. The phasic and tonic contractile response to field stimulation (2, 4, 8, 16, 32 Hz) and bethanechol (3 x -100,000 M) was estimated by polygraph. Following results were obtained. 1) The weight of bladder was increased in obstruction group and gradually decreased after relief of obstruction (p<0.05). 2) The phasic and tonic contractile response to all frequency of stimulation was decreased in obstruction group and rapidly recovered from 4 weeks after relief of obstruction (p<0.05). 3) In low frequency field stimulation, the ratio of tonic to phasic contractile response was decreased in obstruction group when compared with control (p<0.05) and in all frequency field stimulation, the ratio tended to recover after relief of obstruction (p>0.05). 4) Detrusor contractile response to bethanechol was rapidly decreased in obstruction group and rapidly recovered after relief of obstruction. And the contractile response in 6 weeks after relief of obstruction was higher than control (p<0.05). As the results of above, we concluded that relief of bladder outlet obstruction induced recovery of the ability to initiate contraction2 However, emptying ability is not recovered within a certain period of time. And further study will be needed.
Animals ; Bethanechol ; Female ; Humans ; Rats* ; Urinary Bladder Neck Obstruction* ; Urinary Bladder*

OBJECTIVES: Haloperidol has been widely used for treating schizophrenia with somewhat limitation due to the side effects. Some of these side effects are anticholinergic side effects such as dry mouth, constipation, urinary difficulty, blurred vision, sexual dysfunction, etc. Some kinds strategies to minimize these side effects are tried, one of which is the use of bethanechol. The authors studied the effects of bethanechol on the anticholinergic side effects of typical antipsychotics. METHODS: The subjects of this study consisted of 60 chronic schizophrenics who had used haloperidol since 4 weeks before the study and whose score of 'Askers side effects rating scale' was above 7. They were assigned evenly to three groups (placebo group, bethanechol 40mg group, bethanechol 80mg group). Benztropin had been washed out for 2 weeks before the study. The authors measured ASRS for evaluating the anticholinergic side effect and BPRS for evaluating the effects of bethanechol on the psychopathology, at baseline, the 2nd week and the 4th week from baseline, respectively. RESULTS: At baseline, the mean age of patients was 38.00(+/- 10.55) years, the mean duration of illness was 11.12(+/- 8.09) years, and the mean dosage of the haloperidol was 15.07(+/- 6.03)mg. At baseline, mean score of BFRS was 50.25(+/- 5.24), and mean score of ASRS was 9.27 (+/- 3.04). There were no significant differences of ages, duration of illness, dosage of haloperidol, scores of BPRS and ASRS among 3 groups at baseline. There were no significant changes in BPRS at the 2nd week and the 4th week as compared with baseline, and also there were no changes among groups. The total sums of ASRS showed the statistically significant changes in the 80mg group at the 2nd week and the 4th week. The 80mg group showed statistically significant changes in dry mouth, constipation and urinary difficulty dom the 2nd week, and orthostatic symptoms from the 4th week. CONCLUSION: The authors found that the use of bethanechol for the chronic schizophrenics treating with haloperidol greatly improved the anticholinergic side effects with no change in psychopathology. The 80mg group showed more significant results than the placebo group and the 40mg group, especially in dry mouth, constipation, urinary diffculty and orthostatic symptoms. The authors suggest that high doses of bethanechol decrease the anticholinergic side effects and increase the drug compliance of chronic schizophrenics with anticholinergic side effects.
2,5-Dimethoxy-4-Methylamphetamine ; Antipsychotic Agents ; Bethanechol* ; Compliance ; Constipation ; Haloperidol* ; Humans ; Mouth ; Psychopathology ; Schizophrenia