Biomechanics of the Human Urinary Bladder

As a research subject, the biomechanics of the urinary bladder are relatively young, yet medical problems associated with them are as old as mankind. Offering an update on recent achievements in the field, the authors highlight the underlying biological, chemical and physical processes of bladder function and present the systematic development of a mathematical model of the organ as a thin, soft biological shell. The book will be a valuable resource for postgraduate students and researchers interested in the applications of computational mathematics and solid mechanics to modern problems in biomedical engineering and medicine.

1                The Bladder as a Dynamic System

1.1  Anatomy of the human urinary bladder

1.2  Detrusor muscle

1.2.1       Morphology of smooth muscle

1.2.2       Electromechanical activity of the detrusor

1.2.3       Pacemaker activity

1.3  Neurohormonal regulatory system

1.3.1       Anatomical considerations

1.3.2       Neurotransmission

1.3.3       Electrophysiological characteristics of neurons

1.4  Morphofunctional states in the bladder

1.4.1       Bladder filling

1.4.2       Bladder voiding

References

2.         Investigations into Biomechanics of the Bladder

2.1       Biomechanics of the detrusor

2.2       Modelling of the bladder

                  References

3                Geometry of Thin Shells

3.1       The bladder as a thin biological shell

3.2       Geometry of the shell

3.3       Tensor of affine deformation

3.4       Equations of continuity of deformations

3.5       Equations of equilibrium

            References

4.1  Deformation of the shell

4.2  Principal deformations

4.3  Membrane forces

4.4  Principal membrane forces

4.5  Equations of motion in general curvilinear coordinates

4.6  Nets

4.7  Corollaries of the fundamental assumptions

                  References

5                Continual Model of the Detrusor

5.1            Basic assumptions

5.2            Model formulation

5.4            Special cases

References

6                A Model of the Detrusor Fasciculus

6.1            Formulation of the model

6.2            Physiological condition

6.3            Effects of pharmacological and extracellular ion changes on electromechanical activity of the detrusor

6.3.1    Changes in

6.3.2    L- and T-type channel antagonists

6.3.3    BKCa channel agonist/antagonist

6.3.4    K+ channel agonist/antagonist

6.3.5    - ATPase  inhibitors

References

7                The Intrinsic Regulatory Pathways

7.1            Models of electrical activity of neurons

7.2            A model of neuronal assembly in the bladder

7.3            Response of the detrusor to stretching

7.4            Pharmacology of the neuronal pathway

7.4.1       Effect of iberiotoxin and charybdotoxin

7.4.2       Effect of ω-CgTX

7.4.3       Effect of TTX

7.4.4       Effect of purinoceptor agonists

7.4.5       Effect of protein kinase C activator

References

8                The Synaptic Transmission

8.1            A model of the synapse

8.2            cAMP-dependent pathway

8.3            PLC-dependent pathway

8.4            Physiological response

8.5            Variations in synaptic neurotransmission

8.5.1       Chloride salts of divalent cations

8.5.2       Change in [ ]

8.5.3       b - bungarotoxin

8.5.4       Botulinum toxin

8.5.5       Tetrodotoxin

8.5.7       Inhibition of neuronal uptake-1 mechanism

References

                  9                Pharmacology of Detrusor Activity

9.1       Classes of drugs

9.2       Current pharmacological therapies of bladder dysfunction

9.3       Model of competitive antagonist action

9.4       Model of allosteric interaction

9.5       Allosteric modulation of competitive agonist/antagonist action

9.6       Effect of cholinergic antagonists/agonists

9.7       Inhibition of catechol-O-methyltransferase

9.8       Effect of b - adrenoceptor antagonists

            References

                  10              Human Urinary Bladder as a Soft Biological Shell

10.1     Basic assumptions

10.2     Model of the bladder

10.3     Bladder mechanics

                              10.3.1  Filling stage

                              10.3.2  Voiding stage

                              10.3.3  Pharmacological modulation of voiding

11                        Challenges in Human Urinary Bladder Mechanics

11.1         Urine-bladder interaction

11.2         Brain-bladder axis

11.3         Bladder substitutes

                  References

Index