Gender-related Fetal Development of the Internal Urethral Sphincter

Oswald, Josef; Heidegger, Isabel; Steiner, Eberhard; Brenner, Erich; Rennau, Michael Ladurner; Pichler, Renate; Becker, Tanja; Loidl, Wolfgang; Horninger, Wolfgang; Fritsch, Helga

doi:10.1016/j.urology.2013.03.096

Cited by 14 publications

(2 citation statements)

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“…However, in women, the longitudinal cells do not form an internal sphincter. Oswald et al found that although the growth of the bladder neck increased proportional to the gestational age, males (20–40-week gestation) have a denser internal sphincter and a significantly narrower bladder neck in comparison to females [ 34 ]. Similarly, Gilpin et al showed that, in human fetuses, the circular SM around the bladder neck and proximal urethra was prominent in males but scant in females [ 35 ].This finding emphasizes the need for a sex-dependent study of the bladder neck during embryogenesis.…”

Section: Cell Populations In or Associated With The Lutmentioning

confidence: 99%

“…They found that the internal sphincter muscle of male fetuses had a significantly larger volume compared to female fetuses, in part due to hypertrophy of the SM at this level, leading to smaller lumens. They postulated that this could be resultant from hypertrophy induced by transient urethral obstruction distal to the bladder neck and hormone influenced (testosterone) dependent growth [ 34 ]. Important in both male and female fetuses, Jin et al found that SM differentiation in the bladder and urethra is crucial for the Wolffian duct orifice descent [ 46 ].…”

Section: Cell Populations In or Associated With The Lutmentioning

confidence: 99%

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Sex differences in lower urinary tract biology and physiology

Abelson

Sun

Que³

et al. 2018

Biol Sex Differ

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Females and males differ significantly in gross anatomy and physiology of the lower urinary tract, and these differences are commonly discussed in the medical and scientific literature. However, less attention is dedicated to investigating the varied development, function, and biology between females and males on a cellular level. Recognizing that cell biology is not uniform, especially in the lower urinary tract of females and males, is crucial for providing context and relevance for diverse fields of biomedical investigation. This review serves to characterize the current understanding of biological sex differences between female and male lower urinary tracts, while identifying areas for future research. First, the differences in overall cell populations are discussed in the detrusor smooth muscle, urothelium, and trigone. Second, the urethra is discussed, including anatomic discussions of the female and male urethra followed by discussions of cellular differences in the urothelial and muscular layers. The pelvic floor is then reviewed, followed by an examination of the sex differences in hormonal regulation, the urinary tract microbiome, and the reticuloendothelial system. Understanding the complex and dynamic development, anatomy, and physiology of the lower urinary tract should be contextualized by the sex differences described in this review.

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Section: Cell Populations In or Associated With The Lutmentioning

confidence: 99%

Section: Cell Populations In or Associated With The Lutmentioning

confidence: 99%

Sex differences in lower urinary tract biology and physiology

Abelson

Sun

Que³

et al. 2018

Biol Sex Differ

View full text Add to dashboard Cite

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Continence and micturition: An anatomical basis

et al. 2014

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Urinary incontinence remains an important clinical problem worldwide, having a significant socio-economic, psychological, and medical burden. Maintaining urinary continence and coordinating micturition are complex processes relying on interaction between somatic and visceral elements, moderated by learned behavior. Urinary viscera and pelvic floor must interact with higher centers to ensure a functionally competent system. This article aims to describe the relevant anatomy and neuronal pathways involved in the maintenance of urinary continence and micturition. Review of relevant literature focusing on pelvic floor and urinary sphincters anatomy, and neuroanatomy of urinary continence and micturition. Data obtained from both live and cadaveric human studies are included. The stretch during bladder filling is believed to cause release of urothelial chemical mediators, which in turn activates afferent nerves and myofibroblasts in the muscosal and submucosal layers respectively, thereby relaying sensation of bladder fullness. The internal urethral sphincter is continuous with detrusor muscle, but its arrangement is variable. The external urethral sphincter blends with fibers of levator ani muscle. Executive decisions about micturition in humans rely on a complex mechanism involving communication between several cerebral centers and primitive sacral spinal reflexes. The pudendal nerve is most commonly damaged in females at the level of sacrospinous ligament. We describe the pelvic anatomy and relevant neuroanatomy involved in maintaining urinary continence and during micturition, subsequently highlighting the anatomical basis of urinary incontinence. Comprehensive anatomical understanding is vital for appropriate medical and surgical management of affected patients, and helps guide development of future therapies.

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