Transurethral Ultrasound: Evaluation of Anatomy and Function of the Rhabdosphincter of the Male Urethra

Abstract

Our sono-morphological data and anatomical histological results strongly suggest that the rhabdosphincter constitutes the main component of the continence mechanism in post-prostatectomy patients. Unlike urethral pressure profiles, which can only reveal zones of higher intraluminal pressure between the bladder and the penile urethra, transurethral ultrasound is highly specific for measurement of the function of the rhabdosphincter.

Intraurethral sonography and the test‐retest reliability of urethral sphincter measurements in women

“…3 My findings corresponded to those of Schaer et al, 1 who also correlated intraurethral sonograms with urethral histologic sections from female cadavers. The hypoechoic longitudinal smooth muscle layer I measured corresponds to the hypoechoic layer measured by Klein 13 did not correspond to the hypoechoic layer measured by Schaer et al, 1 Klein et al, 4 Kirschner-Hermanns et al, 5 or me.…”

“…Those authors noted that the longitudinal smooth muscle layer was easily detectable as a well-defined internal ring. The circular smooth According to Strasser et al, 13 the assessment of rhabdosphincter thickness or cross-sectional area does not provide sufficiently reliable data about muscle continence function because the peripheral aspects cannot be clearly differentiated Figure 2, and the black areas correspond to the hypoechoic layers in Figure 2. The center black area (1; covered by label in this figure) corresponds to the transducer as seen in Figure 2; the inner white area (2), to the mucosa and submucosal connective tissue; the outer black area (3), to the longitudinal smooth muscle (LSM); and the outer white area (4), to the circular smooth muscle and rhabdosphincter (Rhab).…”

“…After repeating the measurement at least 5 times in every patient, they concluded that ⌬RTD was a reproducible measurement because differences in the same patient were negligible. 13 Frauscher et al 7 and Strasser et al 13 found a negative correlation between rhabdosphincter contractility, as measured by ⌬RTD, and grade of stress urinary incontinence.…”

Post-prostatectomy incontinence: Etiology, evaluation, and management

“…[27] This effect is possibly explained by a progressive decrease in the striated muscle cells within the external urinary sphincter with age. [28] Body mass index (BMI), particularly a BMI above 30 kg/m 2 , is also associated with increased peri-operative complications, including incontinence rates that are three times higher than in patients with a lower BMI. [29] Lastly, surgery performed as salvage therapy in those who have previously undergone radiotherapy or cryotherapy tends to be associated with higher rates of incontinence.…”

Challenging non-traumatic posterior urethral strictures treated with urethroplasty: a preliminary report

“…It is believed that after prostatectomy or TURP continence relies only on the external sphincter (11). Anastomotic urethroplasty at the level of the membranous urethra usually destroys the external sphincter mechanism, as observed after repair of posttraumatic posterior urethral strictures (12).…”