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The mode of action of this combination is unknown but presumed to be an antimuscarinic reduction in detrusor overactivity and the alpha\u2010receptor antagonist reduced outflow tract resistance. We have shown with in vitro experiments that in smooth muscles influencing outflow tract resistance (prostate, trigone) there is a profound contractile synergy between adrenergic and muscarinic pathways. We propose the hypothesis that both arms of the combination therapy reduce contractile tone of the outflow tract and that their simultaneous attenuation has a disproportionately large effect on outflow tract resistance. Our data from trigone muscle suggest that adrenergic and muscarinic receptor activation increase the intracellular [Ca<jats:sup>2+<\/jats:sup>] but the adrenergic pathway also operates through Ca<jats:sup>2+<\/jats:sup>\u2010sensitisation of the contractile apparatus, primarily through a PKC\u2010dependent pathway. Neurourol. 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