Main description:

The interface between the urologist and other disciplines in medicine continues to increase as the character of urology continues to change. Urologists have, for example, developed strong links with microbiol ogists over mutual problems of infection in the urinary tract, urolog ists have been involved in the development of modern management of renal disease and especially renal failure, indeed even before the subject of nephrology had been defined. Similarly the links between endocrinology and infertility and more recently links between imaging and urology have led to the mutual benefit of these subjects and certainly to better patient care. The Pharmacology of the urinary tract has proved to be a difficult area of study. Slowly but progressively it has become evident that this is an area of great potential for urologists. Our patients have a range of problems where non-surgical management would be ideal but finding the right drug for the right condition has remained an elusive task. Many of the earlier trials showed an impressive placebo response rate and emphasised the need for well planned controlled clinical trials. The place of such trials in the evaluation of new treatments for urinary symptoms is now unchallenged and uncon trolled data are of little value. This book represents a skillful combination of background infor mation and its clinical application. The review of the pharmacokine tics of the various groups of drugs provides a very useful background to both the use of current drugs and also the prospects for the future.

Contents:

I. Principles of Urinary Tract Pharmacology.- Biology of Smooth Muscle.- 1. The Autonomic Pharmacology of the Urinary Tract.- Autonomic Control of Smooth Muscle.- Actions of Drugs On and Via the Autonomic Nervous System.- Purinergic and Peptidergic Nerves.- 2. Non-autonomic Drugs Acting on the Urinary Tract.- Direct-Acting Drugs.- Prostaglandins.- Hlstannne.- 5-Hydroxytryptamine.- Calcium Antagonists.- Phenothiazines.- Cardiac Glycosides.- Narcotics.- Anaesthetics.- 3. Pharmacology of the Urinary Tract Striated Muscle.- Anatomy.- Physiology.- Drugs Acting on the Striated Muscle.- II. Use of Pharmacological Agents in Urinary Tract Disorders.- 4. Effects of Drugs on the Ureter and Renal Pelvis.- Rationale of Using Drugs in Ureteric Diseases.- Ureteric Physiology and Pathophysiology.- Sites of Drug Actions.- Posology.- The Use of Drugs in Ureteric Diseases.- Clinically Available Drugs with a Known Effect on the Ureter.- Drugs which Show the Promise of Influencing Ureteric Activity.- 5. Pharmacological Management of the Neuropathic Bladder and Urethra.- Neural Control of Micturition.- Mechanism of Normal Micturition.- Definition and Types of Neuropathic Bladder and Urethra.- Types of Neuropathic Sphincter.- General Principles of Therapy.- Pharmacotherapy of Neuropathic Bladder and Urethra.- 6. Pharmacological Treatment of Non-neurogenic Voiding Dysfunction.- Principles of Pharmacotherapy for Voiding Dysfunction: Evaluation of Drug Effects on Lower Urinary Tract Function.- Failure to Empty.- Failure to Store.- 7. Pharmacological Treatment of Benign Prostatic Hypertrophy.- Rationale of Pharmacological Treatment.- Clinical Correlations.- Actions of Alpha-Adrenergic Blockers in Benign Prostatic Hypertrophy.- Clinical Results.- Acute Retention.- Indications for Pharmacological Treatment.- Dosage and Administration.- Side-Effects and Dangers.- Contraindications to Pharmacological Treatment.- 8. The Use of Adrenocortical Steroids in Urology.- Disease Therapy.- Appendix. Common Proprietary Equivalents of Drugs Mentioned in the Text.