Background: Smooth muscle fibers can be stimulated with an electrical field, high potassium or carbachol. We studied the effect of combined, supramaximal stimulation on the isometric force and the maximum shortening velocity of the pig urinary bladder. Materials and Methods: After determining the dose response curve of each stimulation type, we stimulated 8 fibers with cumulative addition of supramaximal stimuli. Results: The isometric force elicited with either potassium, carbachol or electrical field stimulation alone was the same for each stimulus. After addition of a second or third different supramaximal stimulus, the force further increased to a value that was on average 40% higher. Conclusions: Carbachol, high potassium or electrical field stimulation work through different stimulation pathways. Maximum stimulation with one of the stimuli does not result in a maximum isometric force development and maximum shortening velocity.

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