Topographic and anatomical characteristics of the bladder neck in early fetuses

Aim. To determine macro-and microscopic anatomical characteristics and the dynamics in topographic and anatomical interactions of the bladder neck with adjacent organs and structures at the beginning of the fetal period. Material and methods. The study was carried out on 70 fetal specimens. The age of subjects included in the study was determined according to the tables of B.M. Patten, B.P. Khvatova, Yu.N. Shapovalov based on measurements of the parietal-calcaneal length (PCL), taking into account the Instructions for determining the perinatal period, live birth, and stillbirth criteria, approved by Order of the Ministry of Health of Ukraine No. 179 dated March 29, 2006. To achieve this goal, the following methods of anatomical research were used: anthropometry - to determine the age of the studied subjects; injection of arterial vessels with subsequent dissection under the control of a microscope – to study the peculiarities of the blood supply to the vesicoureteral segment; radiography - to determine the skeletotopy of the vesicoureteral segment; macro-microscopy – to explore the anatomical relationships of the components of the vesicoureteral segment, their structure, shape, position; histological – to study the structure of the wall of the vesicoureteral segment; morphometry – to determine the morphometric parameters of the vesicoureteral segment; 3-D reconstruction method – to study the spatial structure of the vesicoureteral segment; statistical – to analyze and establish the reliability of differences in organometric parameters.Results. Skeletopically, the projection of the vesicoureteral junction of early fetuses is located at the level of the upper third of the pubic symphysis. At the beginning of the perinatal period in female fetuses, the bladder neck (6.9 ± 2.6 mm) is longer than in male fetuses (6.4 ± 2.4 mm). Based on the analysis and generalization of the research results, it is substantiated that at the beginning of the fetal period, the internal urethral sphincter can be formed: a) by two loops of the outer longitudinal layer; b) the ring of the circular layer and the front bundles of the outer longitudinal layer; c) anterior bundles of the outer longitudinal layer and transverse bundles of the inner longitudinal layer within the trigone of urinary bladder; d) a ring of the circular layer, thickened in the anterolateral sections.Conclusions. Considering the topographic and anatomical characteristics of the angio- and myoarchitectonics of the vesicoureteral segment, we believe that its role as a physiological sphincter of the lower urinary tract is provided by the interaction of the vascular and muscle components. The vascular component of the sphincter apparatus of the vesicoureteral segment is provided by veins located in three layers: 1) cavernous-like veins of the submucosa; 2) veins of the muscular membrane; 3) veins of tunica adventitia. The second anatomical component of the sphincter function of the vesicoureteral segment is the muscular one, represented by the internal urethral sphincter.

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Do bladder neck mobility and urethral sphincter function differ during pregnancy compared with during the non-pregnant state?

International Urogynecology Journal ◽

10.1007/bf02199575 ◽

1998 ◽

Vol 9 (6) ◽

pp. 397-403 ◽

Cited By ~ 20

Author(s):

S. Meyer ◽

O. Bachelard ◽

P. De Grandi

Keyword(s):

Bladder Neck ◽

Urethral Sphincter ◽

Sphincter Function ◽

Pregnant State ◽

Neck Mobility ◽

Bladder Neck Mobility

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Effect of prostatic apex shape (Lee types) and urethral sphincter length in preoperative MRI on very early continence rates after radical prostatectomy

International Urology and Nephrology ◽

10.1007/s11255-021-02809-7 ◽

2021 ◽

Author(s):

Mike Wenzel ◽

Felix Preisser ◽

Matthias Mueller ◽

Lena H. Theissen ◽

Maria N. Welte ◽

...

Keyword(s):

Logistic Regression ◽

Radical Prostatectomy ◽

Regression Models ◽

Urethral Sphincter ◽

Anatomical Characteristics ◽

Logistic Regression Models ◽

Pad Test ◽

Type D ◽

Multivariable Logistic Regression ◽

Type C

Abstract Purpose To test the effect of anatomic variants of the prostatic apex overlapping the membranous urethra (Lee type classification), as well as median urethral sphincter length (USL) in preoperative multiparametric magnetic resonance imaging (mpMRI) on the very early continence in open (ORP) and robotic-assisted radical prostatectomy (RARP) patients. Methods In 128 consecutive patients (01/2018–12/2019), USL and the prostatic apex classified according to Lee types A–D in mpMRI prior to ORP or RARP were retrospectively analyzed. Uni- and multivariable logistic regression models were used to identify anatomic characteristics for very early continence rates, defined as urine loss of ≤ 1 g in the PAD-test. Results Of 128 patients with mpMRI prior to surgery, 76 (59.4%) underwent RARP vs. 52 (40.6%) ORP. In total, median USL was 15, 15 and 10 mm in the sagittal, coronal and axial dimensions. After stratification according to very early continence in the PAD-test (≤ 1 g vs. > 1 g), continent patients had significantly more frequently Lee type D (71.4 vs. 54.4%) and C (14.3 vs. 7.6%, p = 0.03). In multivariable logistic regression models, the sagittal median USL (odds ratio [OR] 1.03) and Lee type C (OR: 7.0) and D (OR: 4.9) were independent predictors for achieving very early continence in the PAD-test. Conclusion Patients’ individual anatomical characteristics in mpMRI prior to radical prostatectomy can be used to predict very early continence. Lee type C and D suggest being the most favorable anatomical characteristics. Moreover, longer sagittal median USL in mpMRI seems to improve very early continence rates.

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Regulation by autonomic nerves of bladder neck sphincter function-mainly on inhibitory NANC nerves-

Folia Pharmacologica Japonica ◽

10.1254/fpj.121.299 ◽

2003 ◽

Vol 121 (5) ◽

pp. 299-306

Author(s):

Yojiro UKAI ◽

Kumiko NODA ◽

Noboru TODA

Keyword(s):

Bladder Neck ◽

Autonomic Nerves ◽

Sphincter Function

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Descent of the bladder neck: a urographic finding in denervation of the urethral sphincter in children with myelodysplasia.

Radiology ◽

10.1148/radiology.174.3.2305066 ◽

1990 ◽

Vol 174 (3) ◽

pp. 833-836 ◽

Cited By ~ 11

Author(s):

J M Zerin ◽

R L Lebowitz ◽

S B Bauer

Keyword(s):

Bladder Neck ◽

Urethral Sphincter

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The three muscle layers in the pyloric sphincter and their possible function during antropyloroduodenal motility

Scientific Reports ◽

10.1038/s41598-021-99463-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Mi-Sun Hur ◽

Seunggyu Lee ◽

Tong Mook Kang ◽

Chang-Seok Oh

Keyword(s):

Outer Layer ◽

Longitudinal Muscle ◽

Middle Layer ◽

Comprehensive Approach ◽

Pyloric Sphincter ◽

Muscular Tissue ◽

Micro Ct ◽

Circular Layer ◽

Korean Adult ◽

Longitudinal Layer

AbstractThis study was conducted to determine the muscular arrangement of the human pyloric sphincter using a comprehensive approach that involved microdissection, histology, and microcomputed tomography (micro‐CT). The stomachs of 80 embalmed Korean adult cadavers were obtained. In all specimens, loose muscular tissue of the innermost aspect of the sphincter wall ran aborally, forming the newly found inner longitudinal muscle bundles, entered the duodenum, and connected with the nearby circular bundles. In all specimens, approximately one-third of the outer longitudinal layer of the sphincter entered its inner circular layer, divided the circular layer into several parts, and finally connected with the circular bundles. Anatomical findings around the sphincter were confirmed in micro-CT images. The sphincter wall comprised three layers: an inner layer of longitudinal bundles, a middle layer of major circular and minor longitudinal bundles, and an outer layer of longitudinal bundles. The stomach outer longitudinal bundles were connected to the sphincter circular bundles. The inner longitudinal bundles of the sphincter were connected to the adjacent circular bundles of the duodenum.

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Cholinergic nerve-mediated excitation in the guinea pig choledochoduodenal junction activated by distension

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1994.267.5.g938 ◽

1994 ◽

Vol 267 (5) ◽

pp. G938-G946 ◽

Cited By ~ 1

Author(s):

F. Vogalis ◽

R. R. Bywater ◽

G. S. Taylor

Keyword(s):

Smooth Muscle ◽

Guinea Pig ◽

Action Potential ◽

Action Potentials ◽

Discharge Rate ◽

Circular Muscle ◽

Muscle Layer ◽

Circular Muscle Layer ◽

Circular Layer ◽

Longitudinal Layer

The electrical basis of propulsive contractions in the guinea pig choledochoduodenal junction (CDJ), which are triggered by distension, was investigated using intracellular microelectrode recording techniques. The isolated CDJ was placed in a continuously perfused tissue chamber at 37 degrees C. Membrane potential was recorded from smooth muscle cells in either the ampulla or in the upper CDJ (upper junction) regions, which were immobilized by pinning. Distension of the upper junction (20-30 s) by increasing intraductal hydrostatic pressure (mean elevation: 2.0 +/- 0.3 kPa, n = 13) triggered "transient depolarizations" (TDs: < 5 mV in amplitude and 2-5 s in duration) and action potentials in the circular muscle layer of the ampulla. The frequency of TDs in the ampulla was increased from 2.2 +/- 0.2 to 15.9 +/- 2.2 min-1 (n = 13) during distension. Simultaneous impalements of cells in the longitudinal and circular muscle layers in the ampulla revealed that subthreshold TDs in the circular layer were associated with an increased rate of action potential discharge in the longitudinal layer. Atropine (Atr; 1.4 x 10(-6) M) and tetrodotoxin (TTX; 3.1 x 10(-6) M blocked the distension-evoked increase in TD frequency, without affecting the frequency of ongoing TDs. The sulfated octapeptide of cholecystokinin (1-5 x 10(-8) M) increased the amplitude of TDs recorded in the circular muscle layer of the ampulla and increased action potential discharge rate. In separate recordings, radial stretch of the ampulla region increased the rate of discharge of action potentials in the smooth muscle of the upper junction.(ABSTRACT TRUNCATED AT 250 WORDS)

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Electrical and mechanical interactions between the muscle layers of canine proximal colon

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1990.258.3.g484 ◽

1990 ◽

Vol 258 (3) ◽

pp. G484-G491 ◽

Cited By ~ 1

Author(s):

P. J. Sabourin ◽

Y. J. Kingma ◽

K. L. Bowes

Keyword(s):

Membrane Potential ◽

Circular Muscle ◽

Longitudinal Direction ◽

Proximal Colon ◽

Slow Waves ◽

The Other ◽

Potential Oscillations ◽

Circular Layer ◽

Longitudinal Layer ◽

Membrane Potential Oscillations

Electrical and mechanical interactions between the two smooth muscle layers of canine colon have been studied using a dual sucrose gap apparatus. Muscle samples were dissected into an L-shape, with one leg cut in the circular direction and the other cut in the longitudinal direction. Longitudinal muscle was removed from the circular leg and circular muscle was removed from the longitudinal leg. The bend of the L contained both layers. The activity of the two layers was studied simultaneously under basal conditions, after stimulation by neostigmine and carbachol, and in the presence of tetrodotoxin. Interactions were more common after stimulation and were marked by modification of one layer's mechanical and electrical activity during increased activity in the other layer. Two patterns were commonly observed. First, during a burst of membrane potential oscillations and spike potentials in the longitudinal layer, slow waves in the circular layer developed spike potentials and some slow waves were also prolonged. Second, during a slow-wave cycle in the circular layer, the amplitude of membrane potential oscillations in the longitudinal layer was increased with an associated increase in the incidence of spike potentials. These interactions were associated with contractions of increased strength, which were similar in both layers. All interactions continued after nerve-conduction blockade by tetrodotoxin.

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Bladder Neck Rupture following Perineal Bull Horn Injury: A Surgical Challenge

Clinical Medicine Insights Case Reports ◽

10.4137/ccrep.s10234 ◽

2012 ◽

Vol 5 ◽

pp. CCRep.S10234

Author(s):

B. Padilla Fernandez ◽

F.J. Diaz Alferez ◽

M.A. Garcia Garcia ◽

M. Herrero Polo ◽

J.F. Velasquez Saldarriaga ◽

...

Keyword(s):

Bladder Neck ◽

Bone Fractures ◽

Pubic Symphysis ◽

Pelvic Fractures ◽

Abdominal Injuries ◽

Polytraumatized Patient ◽

Posterior Urethra ◽

The Right ◽

Rupture Of The Bladder ◽

Simultaneous Rupture

Pelvic-abdominal injuries caused by goring are serious lesions which require rapid diagnosis and urgent treatment in the context of a polytraumatized patient. The simultaneous rupture of both the bladder and the prostatic-membranous urethra occurs in 10%-29% of males with pelvic fractures but bladder neck injuries in adults are rarer. Unstable pelvic fractures, bilateral fractures of the ischiopubic branches (also referred to as fractures from falling astride) and the diastasis of the pubic symphysis are those that have the greatest likelihood of injuring both the posterior urethra and the bladder. We present a case of perineal bull horn injury with muscle laceration, bone fractures, scrotal avulsion and rupture of the bladder neck involving the right ureter which required two operations to be repaired.

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Medical treatment of urinary incontinence in the bitch

Vlaams Diergeneeskundig Tijdschrift ◽

10.21825/vdt.v88i1.11399 ◽

2019 ◽

Vol 88 (1) ◽

pp. 3-8

Author(s):

J. Timmermans ◽

B. Van Goethem ◽

H. De Rooster ◽

D. Paepe

Keyword(s):

Risk Factors ◽

Urinary Incontinence ◽

Medical Treatment ◽

Bladder Neck ◽

Daily Practice ◽

Urethral Sphincter ◽

Common Condition ◽

Potential Risk Factors ◽

Urine Leakage ◽

Sphincter Mechanism

Urinary incontinence, an uncontrolled urine leakage during the storage phase of micturition, is a common condition in female dogs. In intact bitches, the reported prevalence is only 0.2-0.3%, but in spayed bitches it varies between 3.1-20.1%. Most commonly, dogs with acquired urinary incontinence suffer from urethral sphincter mechanism incompetence. This condition seems tobe multifactorial, and although the exact pathophysiology remains unclear, potential risk factors include gender, gonadectomy, breed, body weight, urethral length and bladder neck position. In daily practice, the diagnosis of urethral sphincter mechanism incompetence is usually made after eliminating other potential causes of urinary incontinence. Incontinent bitches are primarily treated with medications, such as alpha-adrenergic drugs, e.g. phenylpropanolamine and oestrogens. Surgery is recommended when patients become refractory to medical treatment.

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