Role of Striated Muscle in Urination

Lapides, Jack; Sweet, Robert B.; Lewis, Louis W.

doi:10.1016/s0022-5347(17)66549-2

Cited by 125 publications

(23 citation statements)

References 4 publications

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“…Some earlier studies stated two separate compartments, the striated and smooth muscles must be injured to cause incontinence. [13][14][15] However, a recent study showed that the inner smooth muscle and external sphincter muscle are developmentally inseparable. 12 Our results confirm the latter finding in two aspects.…”

Section: Discussionmentioning

confidence: 99%

A cadaveric histological investigation of the prostate with three-dimensional reconstruction for better results in continence and erectile function after radical prostatectomy

Özdemir

Eskiçorapçı

Baydar

et al. 2006

Prostate Cancer Prostatic Dis

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In this study our aim is to increase the understanding of the prostate and related organs anatomy for better continence and erectile function results after urological surgery. Prostate and related organs were dissected from seven cadavers. After dissection, 165 serial sections with 300 lm thickness were derived at a 100 lm interval. The histological images were examined and imported to the computer. Three-dimensional (3D) remodeling had been performed. The findings were evaluated into three categories: macroscopic, microscopic and 3D reconstruction. Striated muscle fibers had been detected at the anterior fibromuscular stroma in histological sections. In 3D remodeling, urethra seemed to be a complete functional unit, beginning from the trigone up to the membranous urethra. The neurovascular bundles run under the pelvic fascia on both sides and go through to the bladder neck at 5 and 7 o'clock. Computer remodeling demonstrated that neurovascular structures had a close association with the bladder neck and the seminal vesicle. Computer program made it possible to rotate all 3D-reconstructed figures by 3601 and examine them from all possible angles. All reconstructed structures can be examined together at the same time or one by one. Surgeons must pay special attention to the continence area described as a single unit, beginning from trigone to the membranous urethra, during the surgery. Meticulous dissection of the neurovascular bundles, especially close to the seminal vesicles and bladder neck, during the radical prostatectomy is necessary. These reconstructions can be used for the educational purpose of medical students as well as the urology surgeons.

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Section: Discussionmentioning

confidence: 99%

A cadaveric histological investigation of the prostate with three-dimensional reconstruction for better results in continence and erectile function after radical prostatectomy

Özdemir

Eskiçorapçı

Baydar

et al. 2006

Prostate Cancer Prostatic Dis

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“…The role of abdominal muscles in the micturition of human beings has been controversial for several years (8,33,52,57,70). Abdominal straining during voiding has been considered to reflect urethral dysfunction.…”

Section: Perspectivesmentioning

confidence: 99%

Abdominal muscle activity during voiding in female rats with normal or irritated bladder

Cruz¹,

Downie²

2006

American Journal of Physiology-Regulatory, Integrative and Comp

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Cruz, Yolanda, and John W. Downie. Abdominal muscle activity during voiding in female rats with normal or irritated bladder. Am J Physiol Regul Integr Comp Physiol 290: R1436 -R1445, 2006. First published December 22, 2005 doi:10.1152/ajpregu.00556.2005The aims of the present study were to determine in female rats whether abdominal muscle discharges during normal voiding and to describe the effect of bladder irritation on this visceromotor activity. The sensory pathway of this reflex was also determined. Electromyograms (EMGs) indicated that in awake rats, the abdominal muscle was consistently activated during spontaneous voiding and during voiding induced by saline infusion. Similarly, in anesthetized animals, the muscle discharged during urine expulsion. The abdominal EMG activity was not abolished by hypogastric (Hgnx) or sensory pudendal neurectomy (SPdnx). SPdnx dramatically decreased the intercontraction interval and voided volume. Acetic acid infusion reduced the intercontraction interval and increased bladder contraction duration. It also reduced the pressure threshold for evoking the abdominal EMG response and increased the EMG duration and amplitude. Although SPdnx and Hgnx modified some urodynamic parameters, they did not reverse the acetic acid effect on EMG activity. Thus the afferents activating the visceromotor reflex during normal voiding and the increased reflex in response to acetic acid are probably both carried by the pelvic nerve. Abdominal muscle activity induced by bladder distension has been considered to be a pain marker. However, we conclude that in female rats, the abdominal muscle is reflexively activated during physiological urine expulsion. On the other hand, bladder irritation is marked by an exaggeration of this abdominal visceromotor reflex. urethral sphincter; acetic acid; sensory pudendal nerve; hypogastric nerve MICTURITION REQUIRES THE coordinated activity of the bladder, the urethra, and the external urethral sphincter (EUS). This coordination is mediated by multiple reflex pathways organized in the brain and spinal cord. Some reflexes promote urine storage, whereas others facilitate voiding.In rats, several motor reflex pathways are activated during voiding. Striated muscles such as EUS, external anal sphincter, pubococcygeous, cremaster, bulbocavernosus, and ischiocavernosus discharge simultaneously with the bladder contraction (14, 50, 60 -62). Burst activity of the striated sphincter during voiding is necessary for efficient bladder emptying muscle (32,61). Perineal activity may contribute to expulsion of urine (14).The striated muscle reflexes of micturition can be modulated by nociceptive pathways. Thus, although muscles such as external anal sphincter and EUS are activated by the innocuous stimulus of normal voiding in rats, the activity is increased during voiding in animals with mild lower urinary tract irritation (62).Contraction of abdominal musculature in response to visceral noxious stimulation has been considered to be a pseudoaffective response indicating pa...

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“…There are two opinions. One is that micturi tion can be started as well as stopped by direct control over bladder smooth muscle [5]. The other is that the activity of striated muscle is necessary for the voiding of urine [6].…”

Section: Discussionmentioning

confidence: 99%

Change of External Urethral Sphincter Function in Prostatic Patients

Yasuda¹,

Nagashima²,

Murayama³

et al. 1991

Urol Int

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External urethral function was urodynamically examined in 13 patients with benign prostatic hypertrophy (BPH) associated with chronic urinary retention and in 5 volunteers. Prevoiding drop in external urethral sphincter pressure was noted in all the volunteers, whereas it was not found in 6 of the 13 cases of BPH. Bladder neck opening pressure was higher in these 6 cases (p < 0.05). After administration of phentolamine, prevoiding drop was noted in 5 of these 6 cases and bladder neck opening pressure decreased so much that there was no significant intergroup difference. The above results mean that the increase in α-adrenergic receptors makes the prostate, which has been already hypertrophied, less elastic, inhibiting external urinary sphincter function.

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Role of Striated Muscle in Urination

Cited by 125 publications

References 4 publications

A cadaveric histological investigation of the prostate with three-dimensional reconstruction for better results in continence and erectile function after radical prostatectomy

A cadaveric histological investigation of the prostate with three-dimensional reconstruction for better results in continence and erectile function after radical prostatectomy

Abdominal muscle activity during voiding in female rats with normal or irritated bladder

Change of External Urethral Sphincter Function in Prostatic Patients

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