Systemic Nitric Oxide Augmentation Leads to a Rapid Decrease of the Bladder Outlet Resistance in Healthy Men

ObjectiveWe examined the immediate effect of a systemic nitric oxide augmentation on the bladder outlet resistance in healthy men.MethodsEleven healthy male volunteers with a mean age of 25.5 yr were included in the study. They were prepared for a standard urodynamic study, and a baseline pressure-flow study was obtained. The subjects were then given 20 mg isosorbide dinitrate sublingually, and after refilling their bladder a second pressure-flow study was done after 20 min. The pressure-flow studies were then compared in regard to the average flow rate, the average detrusor pressure during micturition, and the detrusor pressure at maximum flow rate.ResultsOne of the subjects was unable to void and had to be excluded from the study. In the remaining 10 men, the mean average flow rate increased from 16.7 ml/s before to 20.2 ml/s after the intake of the NO donor (P = 0.013). Concomitantly, the average detrusor pressure during micturition decreased from a mean of 57 to 52 cm H2O (P = 0.004) and the mean detrusor pressure at maximum flow rate decreased from 60 to 52 cm H2O (P = 0.013).ConclusionsSystemic NO augmentation can lower the functional bladder outlet resistance very rapidly in men. Our results support the concept that the NO-cGMP pathway may be a promising target for medical treatment of lower urinary tract symptoms.