Effect of Voluntary Retention of Urine on Plasma and Urinary

.Januerv-March
1982
Ind. J. Phvsio L Pharrnac.
ion. Presence of'S' cell In GALT
on inhibits homologous antibody
GALT and BM bv v-ravs on the
delayed hypersensitivity response
gs whereas in ATS treated group
antitesticular anti body formation
ekof allergization, which reduced
BM irradiated guineapigs, antiek of allergization.
Antikidney
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EffECT OF VOLUNTARY
RET NTIO:\" OF URINE ON PLASl\1A AND URI~ARY
llIOGE0;IC Al\fIKES AS WELL AS CIRCULATORY
AND RESPIRATORY
RESPONSES
MADHU
SHUKLA
S. N
AND
Institute of Medical Sciences,
Banaras Hindu University. Verenss) - 22 J 005
on March 20. 1981)
Summary : Stress caused by voluntary retention of urine in 25 normal healthy volunteers has been
estimated by mtasuring the levels of biogenic amines (Serotonin, catecholamine)
n blood and urine.
Estimations were done before and after voluntary retension of urine.
phocytic antibody and antibody fragments
. Lancet, 1 : 1126-1127, 1967.
P. K. DEY
Department of Kayachikitsa and Physiology.
(Heceivad
tonsil !liaca of the embryonic and neonatal
TRIPATHI
and 5-HT siqnificantlv
ncreased after retention.
Simultaneously
Plasma and urine catecho!amines
rise in BP, PR. RR were also observed .
Inference has been drawn that retention of urine may induce stress.
tannic acid and subsequent haemagglutina. Sutherland and R. A. Good.
Lancet, 1
Key words
: catecholamine (CA)
urge sensitivity lime
serotonin
5-hydroxyindole
(5-HT)
acetic acrd (5-H1AA)
guage Book Society. 7th edition, 1965.
Iyarthritis in rat by hetrologus antilymphocyte
Pub.Williams and Wilkins Co.. Baltimore
o thymus glands and Iymphocytes.
The mammalian homologue
Science,
of the
avian
destruction of lymphoid tissue I. Lymphotatlon,2 : 60-74. 1964.
Comparisonof rabbit antimouse thymus sera
sptsnteuon, 8 : 249-257, 1969.
ell surfaceimmunoglobulin XIV.
Synthesis,
cells in mouse. J. Immunol., 115 : 603.
Iymphocyte antisera to
1961.
inhibit hypersensi-
letion by thoracic duct fistula and adminisin rats. Ann. N. Y. Acad. SCI., 120 : 119-
INTRODUCTION
As early as 1899. Sherrington demonstrated
that reflex vascular responses are
obtained by the distension of certain
hollow visceras.
Later on the same has been
established in experimental
animals as well as in human subjects (7,11.13,16).
It has
been suggested that the
pressor response was brought about refJexly by splanchnic
vasoconstriction and active vasoconstriction
in the renal circulation
(11, 13) as this
pressor response was totally abolished after the bilateral
splanchnicotomy
(11).
On
the contrary, Prabhaker et al. (13) have observed that even after the ganglion blockade
and reserpine the rise in blood pressure was not abolished. indicating the release of some
vasoconstrictfng humoral substances in the circulation
responsible
for the increase in
blood pressure.
the voluntary
retention of urine and the
In the literature of Indian medicine.
other natural urges also have been considered to be very important factor in the etioloqv
62
January-March
198!
Ind. J. Physiol. Pharmac
Shukla et al.
of severa I endogenous stress disorders.
Therefore. the present investigation has been
undertaken to observe the level of vasoconstricting
hurnors (catecholamine
(CA). serotorun (5-HT) alongwith
measurement of blood pressure before and after voluntary retention
olume 26
Number
1
increased significantly ~
creased significantly (
TABLE
of urine.
MATERIALS
AND
METHODS
Efl
Parameters
S. No.
In a series of 25 normal healthy human volunteers of 20-45 years. the effect of
retention of urine on biogenic
amines and certain physiological
parameters has been
examined.
I:
A.
B ir)genic emtnes :
1.
Urinary Cf... (!iq/?5
2.
Urinary
3
Plasma CA. {!iq/ml
5-HIAA.
(m
Plasma 5-HT (nq/
In the morning at about 8 AM .. the blood and urine samples were collected and
4.
Physlohgical
pereme
B.
the blood pressure. pulse rate. respiration
rate
were recorded.
Then the volunteers
B. P. (mm. Hg)
5.
were given 1.5 litres of water to drink and instructed to hold the urine as long as possible
(i) Systolic
and report the first feeling of micturition
After maximum voluntary
holding.
the
(ii) Diastolic
blood sample was collected and the blood pressure. pulse rate. and respiration rate were
Respiration rate
6.
recorded
Then volunteers were allowed to pass urine which was collected.
The time
Pulsp rate
7.
of drinking water. the first feeling of micturition and passing of urine were also recorded.•. -----~-------:
Blood samples were collected in heparinized tubes and plasma was subjected
for the fluorornetric estimation of catecholamine (4) and serotonin (15).
Urine samples
were collected
over con.
HCI to maintain pH between 2~3 for stability of catecholamine. Urine was analysed for the catecholamine
(1) and 5-hydroxyindoleacetic
acid
(5- HIAA) estimation (6) which were expressed in terms of creatinine. (cr.).
The results were expressed as mean
±
SEM and comparison
was
done by student
'1' test.
RESULTS
Biogenic
amine changes
Haemodynamic
distension of pelvic org
blood pressure level in
The increased catechola
Pra bha ker et at. (13) th
pressure increment in
supposed to cause the
(10,14.17).
It is an establis
:
There was a significant rise in plasma (p<0.01)
as well as urinary catecholamine
level (p<0.001)
after retention of urine. The plasma 5-HT was also increased but not
very significantly
(p<0.05)
while the urinary 5-HIAA (metabolite
of 5-HT) increase
sed blood pressure and
In the present study th
rise in pulse rate. respi
crease in 5-HT level. .,
was quite significant
(2,5,12).
(P<0.001),
(Table I).
Physiological changes :
As regards the blood
pressure. both the systolic
and diastolic
pressures were
which
Thus it is obvio
is reflected in th
January-March
1982
Ind. J. Physiol. Pharmac.
present investigation has been
mors (catecholamine (CA), serabefore and after voluntary reten-
Biological Amine and Physiological
increasedsignificantly
(P<0.05).
The respiration rate and pulse rate
significantly
(P<0.001
and P<0.02, respectively. Table I).
TABLE
os
I:
Effect of urine retention on biogenic arrunes
Peremcters
rs of 20-45 years. the effect of
ysiologicaI parameters has been
Urinary Cfl.. ((Lg/25 mq of Cr.)
(mg/gm
Plasma CA. ((Lg/mIJ
bes and plasma was subjected
serotonin (15).
Urine samples
2-3 for stability of catecholaand 5-hydroxyindoleacetic
acid
of creatinine. (cr.).
mparison was done by student
as well as urinary catecholamine
-HT was also increased but not
(metabolite of 5-HT) increase
phvsioloqical
63
also in-
responses.
Before
After
'P' value
retention
(a)
retention
(0,'
(a vs b)
BirJgenic emtnes :
Urinary 5-HIAA.
urine samples were collected and
recorded. Then the volunteers
old the urine as long as possible
ximum voluntary
holding.
the
rate. and respiration rate were
which was collected.
The time
ing of urine were also recorded.
and
were
Changes
Plasma 5-HT
(ng/ml)
2.06±0.34
of Cr.)
3 0±0.36
485±0.60
8. 28±0.
<0.001
81
<0.001
10.86±0.45
13.77±0.75
<0.01
0.0510±0.01
0.148±0.39
<0.05
Pnvsrotoqic»! parameters:
B. P. (mm. Hg)
(i) Systolic
(ii)
114.15±3.05
Diastolic
6.
Respiration
7.
Pulse rate
rete
123.4
±2.19
<0.05
71.46±2.02
79.62±2.57
19.72±0.65
?4.77±1.16
<0.001
72.71±2.41
83.51±3.23
<0.02
<0.05
DISCUSSION
Haemodynamic changes have been reported by various workers
following the
distension of pelvic organs specially the bladder and rectum (7.11,13.16).
The increased
blood pressure level in the present study is consistent with the result of these workers.
The increased catecholamine and serotonin level in this study support the suggestion of
Prabhaker et al. (13) that some vasoconstricting
humors also participate in the blood
pressure increment in addition to reflex- mechanism.
Catecholamine and serotonin are
supposed to cause the blood pressure increase due to their vasoconstricting
property
(10.14.17).
It is an established fact that normal individuals respond to stress with the increased blood pressure and catecholamine execretion due to sympathetic stimulation (3,8.9,10)
In the present study the bladder distension due to voluntary retention of urine causes
rise in pulse rate, respiration rate. blood pressure and catecholamine
alongwith the increase in 5-HT level. which are also reported to be increased in the stressful situations
(2.5.12).
ic and diastolic
pressures were
Thus it is obvious that retention of urine is capable to produce stress in the body
which is reflected in the physiological as well as biochemical
parameters. Hence. in day
64
.Januarv-March
198!
Ind. J. Physiol. Pharmac
Shukla et al
to day life, it may be a contributory
general and psychosomatic
factor in the aetiology
disorders as envisaged
of endogenous
in the Ayurvedic
diseases n
literature
EFFECT OF E
COAG LATIO
ACTIVITY
ACKNOWLEDGEMENTS
Authors are thankful
to the C.S.I.R. for financial
help.
S GAU
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to sympathetic stimulation
Whole blood cl
were estimate
of 18-25 years. Subjec
ted no t to smoke if the
till the subjects got ex
revolutions/min.
Tota
collected from anti-en
drawn. 1 ml of blood
done in duplicate and a
activity
in pith€d