Purpose: Our current study was designed to determine whether estradiol-induced increases in bladder blood flow could be inhibited by Nω-nitro-L-arginine methyl ester (L-NAME), and thus whether nitric oxide was involved in estrogen-linked female bladder blood flow alterations. Materials and Methods: Sixteen female New Zealand White rabbits were separated into 4 groups of 4 rabbits each. (1) Sham group received sham operation and injections of vehicle (peanut oil). (2) Ovariectomy (OVX) group received ovariectomies and injections of vehicle. (3) Ovariectomy + estrogen (OVX+E) group received ovariectomy and injections of 17β-estradiol (1 mg/kg) dissolved in peanut oil. (4) Ovariectomy + estradiol + L-NAME (OVX+E+L-NAME) group received ovariectomies and injections of 17β-estradiol and L-NAME. All treatments were continued for 4 weeks. At 4 weeks after treatment, each rabbit was anesthetized and cystometries were performed. After cystometry, blood flow to the detrusor muscle and mucosa was determined by standard fluorescent microsphere infusion technique. Then four longitudinal detrusor strips and two rings of descending thoracic aorta were mounted in individual 15 ml baths containing oxygenated Tyrode’s solution at 37°C. Contractile responses to several agents were determined. Full-thickness sections of detrusor were fixed and embedded in paraffin for α-actin immunostaining. Results: In the bladder: (1) Estradiol resulted in an increases in bladder weight and blood flow; L-NAME inhibited these increases. (2) OVX resulted in a decreased cystometric capacity; estradiol resulted in increased capacity which was attenuated by L-NAME treatment. (3) OVX resulted in significantly decreased contractile responses to all forms of stimulation; estradiol resulted in significantly increased contractile responses which were attenuated by L-NAME treatment. (4) OVX resulted in a significant decrease in the volume-fraction of smooth muscle in the detrusor; estradiol resulted in a significant increase which was attenuated by L-NAME. Conclusions: These findings strongly support the hypothesis that nitric oxide plays a major role in the alterations in blood flow mediated by changing circulating estrogen and that these changes mediate at least in part the cystometric and contractile changes induced by alterations in circulating estrogen.

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