THE excellent recent studies of Tanagho and Smith (1966), Hutch (1967), Woodburne (1968) andGil Vernet (1964) have clarified many problems about continence and micturition. However neither the micro-anatomical details of the course of the fibres of the external urethral sphincter nor its exact part in urinary continence and micturition are yet solved in a definite manner.Our working hypothesis is that urinary continence and voiding are controlled in the urethra by 3 complementary factors: the visco-elastic characteristics of the wall, the activity of the striated paraurethral muscles, and the activity of the smooth muscles descending from the detrusor layers.Starting from this hypothesis we made a preliminary study of the electromyographical activity of the paraurethral and perineal muscles, in relation to the pressures in the bladder, urethra and rectum. Normal as well as pathological conditions were examined.

No abstract

The electromyographic patterns of the external urethral sphincter, the anal sphincter, and the levator ani during cystometries have been analyzed. Synchronized activity changes occur during abdominal straining. Muscle fatigue is very pronounced. Activity may be less synchronized during bladder filling and micturition, even in normal cystometries. In neurogenic diseases, true dyssynergia between the striated muscles may be observed.

No abstract

The level of urinary carcinoembryogenic antigen (CEA) was evaluated in the diagnosis and follow-up of urothelial carcinoma of the bladder. Urinary CEA concentration, cystoscopic findings and the histopathology of an eventually resected bladder tumour were correlated in 177 cases. The sensitivity proved to be 34%, the specificity 82%. Possible correlations with sex, infection, primary tumour or recurrence, differentiation and invasion of an eventually resected tumour and influence of adjuvant therapy were also evaluated. A comparison was made with the results of other authors and different factors which may influence urinary CEA levels are discussed.