Urethral closure mechanisms during sneezing-induced stress in anesthetized female cats

2007 ◽  
Vol 293 (3) ◽  
pp. R1357-R1367 ◽  
Author(s):  
V. Julia-Guilloteau ◽  
P. Denys ◽  
J. Bernabé ◽  
K. Mevel ◽  
E. Chartier-Kastler ◽  
...  
Keyword(s):  
Open Abdomen ◽  
Levator Ani ◽  
Urinary Continence ◽  
Abdominal Pressure ◽  
External Urethral Sphincter ◽  
Relevant Model ◽  
Induced Stress ◽  
Pharmacological Studies ◽  
Urethral Closure ◽  
Lower Urinary

During stress-induced increase in abdominal pressure, urinary continence is maintained by urethral closure mechanisms. Active urethral response has been studied in dogs and rats. Such an active urethral response is also believed to occur in humans during stress events. We aimed to investigate urethral closure mechanisms during sneezing in cats. Urethral pressures along the urethra (UP1–UP4), with microtip transducer catheters with UP4 positioned in the distal urethra where the external urethral sphincter (EUS) is located, and intravesical pressure were measured, and abdominal wall, anal sphincter (AS), levator ani (LA), and EUS electromyograms (EMGs) were recorded during sneezing under closed-abdomen and open-abdomen conditions in eight anesthetized adult female cats. Proximal and middle urethral response induced by sneezing was not different from bladder response. Distal urethral response was greater compared with proximal and middle urethral and bladder response. In the open-abdomen bladder, proximal and middle urethral responses were similarly decreased and distal urethral response was unchanged compared with the closed-abdomen bladder. Bladder and urethral responses were positively correlated to sneeze strength. EUS, LA, and AS EMGs increased during sneezing. No urine leakage was observed, regardless of the strength of sneeze. In cats urethral closure mechanisms are partly passive in the proximal and middle urethra and involve an active component in the distal urethra that is believed to result from EUS and possibly LA contractions. Because central serotonin exerts similar effects on the lower urinary tract in cats and humans, the cat may represent a relevant model for pharmacological studies on continence mechanisms.

Urethral closure mechanisms under sneeze-induced stress condition in rats: a new animal model for evaluation of stress urinary incontinence

2003 ◽  
Vol 285 (2) ◽  
pp. R356-R365 ◽  
Author(s):  
Izumi Kamo ◽  
Kazumasa Torimoto ◽  
Michael B. Chancellor ◽  
William C. de Groat ◽  
Naoki Yoshimura
Keyword(s):  
Urinary Incontinence ◽  
Stress Condition ◽  
Female Rats ◽  
Urinary Continence ◽  
Abdominal Pressure ◽  
Intravesical Pressure ◽  
External Urethral Sphincter ◽  
Urinary Leakage ◽  
Induced Stress ◽  
Urethral Closure

The urethral closure mechanism under a stress condition induced by sneezing was investigated in urethane-anesthetized female rats. During sneezing, while the responses measured by microtip transducer catheters in the proximal and middle parts of the urethra increased, the response in the proximal urethra was almost negligible when the bladder response was subtracted from the urethral response or when the abdomen was opened. In contrast, the response in the middle urethra during sneezing was still observed after subtracting the bladder response or after opening the abdomen. These responses in the middle urethra during sneezing were significantly reduced ∼80% by bilateral transection of the pudendal nerves and the nerves to the iliococcygeous and pubococcygeous muscles but not by transection of the visceral branches of the pelvic nerves and hypogastric nerves. The sneeze leak point pressure was also measured to investigate the role of active urethral closure mechanisms in maintaining total urethral resistance against sneeze-induced urinary incontinence. In sham-operated rats, no urinary leakage was observed during sneeze, which produced an increase of intravesical pressure up to 37 ± 2.2 cmH2O. However, in nerve-transected rats urinary leakage was observed when the intravesical pressure during sneezing exceeded 16.3 ± 2.1 cmH2O. These results indicate that during sneezing, pressure increases elicited by reflex contractions of external urethral sphincter and pelvic floor muscles occur in the middle portion of the urethra. These reflexes in addition to passive transmission of increased abdominal pressure significantly contribute to urinary continence mechanisms under a sneeze-induced stress condition.

FUNCTIONAL ASPECTS OF THE FEMALE EXTERNAL URETHRAL SPHINCTER AND LEVATOR ANI MUSCLE IN URETHRAL CLOSURE

2008 ◽  
Vol 179 (4S) ◽  
pp. 535-535
Author(s):  
Christian Wallner ◽  
Noshir F Dabhoiwala ◽  
Marco C DeRuiter ◽  
Wouter H Lamers
Keyword(s):  
Levator Ani ◽  
Levator Ani Muscle ◽  
Urethral Sphincter ◽  
External Urethral Sphincter ◽  
Functional Aspects ◽  
Urethral Closure

scholarly journals Strength of pelvic floor in men: reliability intra examiners

2018 ◽  
Vol 31 (0) ◽  
Author(s):  
Patricia Zaidan ◽  
Fabio Dutra Pereira ◽  
Elirez Bezerra da Silva
Keyword(s):  
Pelvic Floor ◽  
Physical Therapist ◽  
High Reliability ◽  
Intraclass Correlation ◽  
Internal Consistency Reliability ◽  
Urinary Continence ◽  
Abdominal Pressure ◽  
Strength Assessment ◽  
Male Patients ◽  
The Moment

Abstract Introduction: The obtaining of urinary continence is due to the strength of the pelvic floor muscles (MAPs) at the moment of muscle contraction, when there are sudden increases in intra-abdominal pressure, which increases urethral closure pressure and decreases the possibility of urinary loss. Objective: To verify the reliability, type: stability, intra-examiner, of the measure of the strength of MAPs held with Peritron. Methods: Test and retest study to assess the intra-rater reliability of Peritron to measure the strength of MAPs. The sample consisted of 36 male patients, mean age 65.3 ± 7.2 years, all with urinary incontinence (UI) after radical prostatectomy. The physical therapist conducted a training for familiarization with the procedures of MAPs strength assessment with Peritron for two weeks. The strength of MAPs was measured by a perineometer of the Peritron brand (PFX 9300®, Cardio-Design Pty. Ltd, Baulkham Hills, Australia, 2153). Results: The intraclass correlation coefficient (ICC) was equal to 0.99; P = 0.0001. The typical measurement error (ETM) was equal to 3.1 cmH2O and ETM% of 4. Conclusion: Peritron showed high reliability for measuring the strength of MAPs in men, both for clinical practice and for the production of scientific knowledge. It should be noted that such measures were carried out in stability, so it is suggested that in internal consistency reliability is equivalent.

scholarly journals Laparostomy in a rural hospital: an African case report for a very important tool to be spread and increased

2017 ◽  
Author(s):  
Gian Domenico Arzu ◽  
Riccardo Conventi ◽  
Giovanni Putoto ◽  
Emmanuel Onapa
Keyword(s):  
Intestinal Obstruction ◽  
Low Income ◽  
Open Abdomen ◽  
Primary Anastomosis ◽  
Foley Catheter ◽  
Abdominal Sepsis ◽  
Low Income Countries ◽  
Abdominal Pressure ◽  
Second Look ◽  
Aged Woman

Laparostomy is a surgical technique enabling the surgeon to leave abdominal fascial edges opened after a laparotomy. This is a useful tool that can be very important in patients with intraabdominal hypertension. Open abdomen indications are: trauma, severe abdominal sepsis, intestinal infarction, vascular surgery and when the surgeon cannot close the abdomen due to high intra abdominal pressure in order to avoid abdominal compartment syndrome or in case of a second look in order to evaluate the conditions of the abdomen (and particularly of the gut). We used this technique in a low income country for a patient with intestinal obstruction where performing a primary anastomosis during the first operation was at high risk of leakage. A middle-aged woman was admitted in Pope John’s Hospital - Aber, Uganda for abdominal pain and intestinal obstruction (IO) symptoms. A laparotomy found a tract of small gut necrotic and twisted under a single adhesion. The small gut above the volvulus was dilated for the obstruction created by the adhesion. We decided to excise the necrotic intestine and leave the abdomen open for a second look and delayed anastomosis and closure. The managing of the IO was conducted by inserting a big Foley catheter in the proximal intestine to drain its enteric content in a similar fashion to a guided external fistula. Open abdomen is a very important technique, relatively new, that can impact positively in treating some surgical patients even in rural hospitals and in the absence of Intensive Care Unit. A simple trick can solve successfully the IO due to the volvulus. Laparostomy should be spread more in African and low-income countries.

Neuroanatomy of the External Urethral Sphincter: Implications for Urinary Continence Preservation During Radical Prostate Surgery

1995 ◽  
Vol 153 (2) ◽  
pp. 337-341 ◽  
Author(s):  
Perinchery Narayan ◽  
Badrinath Konety ◽  
Khalid Aslam ◽  
Sherif Aboseif ◽  
Walter Blumenfeld ◽  
...  
Keyword(s):  
Urinary Continence ◽  
Urethral Sphincter ◽  
External Urethral Sphincter

Dopaminergic D2 receptors activate PKA to inhibit spinal pelvic-urethra reflex in rats

2010 ◽  
Vol 299 (3) ◽  
pp. F681-F686 ◽  
Author(s):  
Hsi-Chin Wu ◽  
Chun-Hsien Chiu ◽  
Kwong-Chung Tung ◽  
Gin-Den Chen ◽  
Hsien-Yu Peng ◽  
...  
Keyword(s):  
Nmda Receptor ◽  
Receptor Antagonist ◽  
Ampa Receptor ◽  
Receptor Agonist ◽  
Repetitive Stimulation ◽  
Spinal Reflex ◽  
External Urethral Sphincter ◽  
Urethral Closure ◽  
Dependent Inhibition

To clarify the role of descending dopaminergic innervation in reflexive urethral closure, the impacts of dopaminergic D2 receptor (DR2)-selective agonists and antagonists on repetitive stimulation-induced pelvic-to-urethra spinal reflex potentiation (SRP) were tested using in vivo rat preparations. Pelvic afferent nerve test stimulation (TS; 1 pulse/30 s for 30 min) evoked baseline reflex activity with single spikes in the external urethral sphincter electromyogram (EUSE), whereas, repetitive stimulation (RS; 1 pulse/s for 30 min) induced SRP. Intrathecal application of quinelorane dihydrochloride (Q110; 10, 30, and 100 nM, 10 μl, a selective DR2 agonist) dose dependently inhibited the RS-induced SRP. Pretreatment with L135 (100 nM, 10 μL it, a selective DR2 antagonist) antagonized the Q110-dependent inhibition (100 nM, 10 μl it). Intrathecal AMPA (10 μM, 10 μl, a selective glutamatergic AMPA receptor agonist), and NMDA (10 μM, 10 μl, a selective glutamatergic NMDA receptor agonist) reversed the Q110-dependent inhibition. Intrathecal forskolin (100 nM, 10 μl, a PKA activator) prevented the Q110-dependent inhibition that was reversed by CNQX (10 μM, 10 μl it, a selective glutamate AMPA receptor antagonist) and APV (10 μM, 10 μl it , a selective glutamate NMDA receptor antagonist). Our results suggest that DR2 activation, which inactivates intracellular PKA, may be involved in descending dopaminergic inhibition of NMDA/AMPA receptor-dependent SRP at the lumbosacral spinal cord, which is thought to be involved in reflexive urethral closure.

scholarly journals MP64-02 THE KEY ROLE OF LEVATOR ANI THICKNESS FOR EARLY URINARY CONTINENCE RECOVERY IN PATIENTS UNDERGOING ROBOT-ASSISTED RADICAL PROSTATECTOMY: A MULTI-INSTITUTIONAL STUDY

2021 ◽  
Vol 206 (Supplement 3) ◽  
Author(s):  
Manuela Tutolo ◽  
Giuseppe Rosiello ◽  
Dirk De Ridder ◽  
Davide Oreggia ◽  
Francesco Barletta ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Levator Ani ◽  
Urinary Continence ◽  
Robot Assisted

scholarly journals Past, Present, and Future in the Study of Neural Control of the Lower Urinary Tract

2020 ◽  
Vol 24 (3) ◽  
pp. 191-199
Author(s):  
Jin Wook Kim ◽  
Su Jin Kim ◽  
Khae Hawn Kim
Keyword(s):  
Urinary Tract ◽  
Motor Neurons ◽  
Lower Urinary Tract ◽  
Neural Control ◽  
Sympathetic Neurons ◽  
Voluntary Contraction ◽  
Sensory Nerves ◽  
External Urethral Sphincter ◽  
Complex Signals ◽  
Lower Urinary

The neurological coordination of the lower urinary tract can be analyzed from the perspective of motor neurons or sensory neurons. First, sensory nerves with receptors in the bladder and urethra transmits stimuli to the cerebral cortex through the periaqueductal gray (PAG) of the midbrain. Upon the recognition of stimuli, the cerebrum carries out decision-making in response. Motor neurons are divided into upper motor neurons (UMNs) and lower motor neurons (LMNs) and UMNs coordinate storage and urination in the brainstem for synergic voiding. In contrast, LMNs, which originate in the spinal cord, cause muscles to contract. These neurons are present in the sacrum, and in particular, a specific neuron group called Onuf’s nucleus is responsible for the contraction of the external urethral sphincter and maintains continence in states of rising vesical pressure through voluntary contraction of the sphincter. Parasympathetic neurons originating from S2–S4 are responsible for the contraction of bladder muscles, while sympathetic neurons are responsible for contraction of the urethral smooth muscle, including the bladder neck, during the guarding reflex. UMNs are controlled in the pons where various motor stimuli to the LMNs are directed along with control to various other pelvic organs, and in the PAG, where complex signals from the brain are received and integrated. Future understanding of the complex mechanisms of micturition requires integrative knowledge from various fields encompassing these distinct disciplines.

scholarly journals Various significant connections of the male pelvic floor muscles with special reference to the anal and urethral sphincter muscles

2019 ◽  
Vol 95 (3) ◽  
pp. 305-312 ◽  
Author(s):  
Janyaruk Suriyut ◽  
Satoru Muro ◽  
Phichaya Baramee ◽  
Masayo Harada ◽  
Keiichi Akita
Keyword(s):  
Pelvic Floor ◽  
Anal Sphincter ◽  
External Anal Sphincter ◽  
Complex Structure ◽  
Levator Ani ◽  
Levator Ani Muscle ◽  
Urethral Sphincter ◽  
External Urethral Sphincter ◽  
Lateral Aspect ◽  
Close Relationship

AbstractThe male pelvic floor is a complex structure formed by several muscles. The levator ani muscle and the perineal muscles are important components of the pelvic floor. The perineal muscles comprise the external anal sphincter, bulbospongiosus, superficial transverse perineal muscles, and ischiocavernosus. Although the connections of the muscles of the pelvic floor have been reported recently, the anatomical details of each muscle remain unclear. In this study, we examined the male pelvic floor to clarify the connection between the muscles related to function. Fifteen male pelvises were used for microscopic dissection, and three male pelvises were used for histological examination. On the lateral aspect, the perineal muscles were connected to each other. Bundles of the levator ani muscle extended to connect to the perineal muscles. In addition, the extended muscle bundle from the levator ani muscle and the perineal muscles surround the external urethral sphincter. On the medial aspect, the levator ani muscle and the external anal sphincter form the anterior and posterior muscular slings of the anal canal. The connection between the perineal muscles and levator ani muscle indicates a possible close relationship between the functions of the urethra and anus.

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