Malfunctions of the urinary bladder can lead to an excessive urge to urinate and to the dreaded incontinence. However, paralysis of the urinary function is also possible. The patient then feels no urge to urinate and no need to empty the bladder. Such problems can occur after surgery, but they can also be caused by acute diseases. In severe cases, bethanechol may be a remedy that provides relief.
What is bethanechol?
Bethanechol is a drug and is primarily used for certain bladder disorders. Bethanechol is a drug and is primarily used for certain bladder diseases. These include mainly the so-called neurogenic bladder. A healthy bladder stores urine and empties in a coordinated and controlled manner. This coordination is controlled by the central nervous system. If this function of the nervous system is disturbed, one speaks of a neurogenic bladder. Bethanechol acts on the central nervous system and on the parasympathetic nervous system, which is a part of the nervous system. The active ingredient is thought to enhance the action of the parasympathetic nervous system and support the function of a healthy urinary bladder. Bethanechol can also be used to treat bladder atony. Bladder atony is a paralysis of the urinary bladder wall caused by an acute disease of the central nervous system. The patient then feels no urge to urinate even when the bladder is full. Such an acute disease may be, for example, paraplegia.
Pharmacologic effect
Bethanechol acts on the parasympathetic nervous system to support the function of a healthy urinary bladder. The bladder is controlled by muscles and nerves of the urinary system. In this process, nerves carry stimuli from the bladder to the brain and from there to the muscles of the urinary bladder. These muscles provide tension or relaxation, which initiates emptying of the bladder. Pharmacologically, bethanechol increases the tension of the bladder muscle called the detrusor. This increases the filling pressure of the bladder, resulting in a lower bladder capacity. In the urinary bladder, the pressure to empty increases. Thus, Bethanechol leads to increased emptying of the bladder when this function is disturbed by a neurogenic or an acute disease and no longer reacts and empties in the usual way. In addition to contraction of the urinary bladder, the urethra may also contract when bethanechol is given at a very high dose. However, bethanechol acts not only on the bladder, but on the overall activity of the digestive glands. This speeds up the transport of food through the digestive system.
Medical use and application
Bethanechol is used for conditions that require stimulation of the bladder muscle. These include, among others, the inability to empty the bladder after surgery due to paralysis of the bladder muscle. This paralysis may also be caused by a serious acute condition such as paraplegia. A neurogenic disorder of the detrusor may also require administration of bethanechol. Bethanechol is not allowed for impending constipation or for acute constipation. The active ingredient is administered in tablet form. These medications require a prescription and may be taken only as directed by a physician and under a physician’s observation. Bethanechol can only be taken orally, and a slow and steady increase in dosage is possible if the doctor deems it necessary. However, taking it is fraught with potential side effects, which should be observed in any case.
Risks and side effects
The most common side effects observed include changes in heartbeat and increased bronchial muscle response. Patients with pre-existing asthma, in particular, react with a severe contraction of the bronchial tubes and a correspondingly violent cough. Reduced respiratory volume may also be a consequence of taking bethanechol if a previous asthmatic condition is known. In healthy patients and at normal doses, the drug may cause a brief drop in blood pressure. Increased lacrimation and salivation have also been observed in medical practice. In contrast, bethanechol has only minor effects on skeletal muscle. Bones and musculoskeletal apparatus should thus not be affected by undesirable side effects in largely healthy patients.