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PubMed1997

Action of autonomic drugs on the in vivo bladder base and proximal urethra in dog.

OBJECTIVE: To investigate the effects of autonomic drugs on the in vivo bladder base and proximal urethra in order to provide some reference materials for clinical usage of these drugs in the treatment of bladder outlet dysfunction. METHODS: In 35 dogs, the bladder base was separated from the bladder body and closed to constitute a small chamber. The changes of the pressure in the bladder base chamber and proximal urethra were recorded synchronously before and after administration of autonomic drugs. All data were analyzed with Student's t test. RESULTS: The bladder base had little response to acetylcholine (Ach) which however promoted a contraction of the proximal urethra. The effect of Ach on the proximal urethra was antagonized by phentolamine, but not by atropine. Isoprenaline resulted in relaxation of the bladder base, though it had little effect on the urethra. Norepinephrine (NE) produced contraction of the bladder base and urethra, while phentolamine caused a reduction in the bladder base and urethral pressure, and blocked the response of the bladder outlet region to NE. Angiotensin amide (AII) caused contraction of the bladder base and urethra, which was not obliterated by phentolamine. CONCLUSIONS: The cholinergic drug has no influence on the in vivo canine bladder base, but causes a contraction of the proximal urethra through indirect activation of alpha-receptors. The alpha-adrenergic agents have great effects on the bladder base and urethra by acting on alpha-receptors within the musculature in the outlet region. The beta-adrenoceptor agonist results in relaxation of the bladder base, but it has no effect on the urethra.

Acetylcholine↗
PubMed1996

Detection of human papillomavirus DNA in primary squamous cell carcinoma of the male urethra.

OBJECTIVES: The prevalence of human papillomavirus deoxyribonucleic acid (DNA) in primary squamous cell carcinoma of the male urethra and corresponding control tissue was studied. METHODS: The technique of polymerase chain reaction DNA amplification was used to detect specific human papillomavirus DNA sequences in archival pathologic and control tissue. We analyzed 16 cases of primary squamous cell carcinoma of the male urethra and 22 specimens of normal male urethra stratified by location within the urethra. RESULTS: Primary squamous cell carcinoma of the pendulous urethra was significantly associated with human papillomavirus type 16 DNA (6 of 6 cases), but the control tissue from the pendulous urethra was not (0 of 12, P < 0.001). Primary squamous cell carcinoma of the bulbous and posterior urethra was not associated with human papillomavirus infection. CONCLUSIONS: Infection of the male urethra with human papillomavirus type 16 may have a role in the pathogenesis of primary squamous cell carcinoma of the pendulous urethra, for which it has a strong predilection, vis-à-vis the bulbous and posterior urethra.

Carcinoma, Squamous Cell↗
PubMed2004

[Contrast-enhanced sonourethrography versus conventional miction cystourethrography in the assessment of the urethra: preliminary study].

BACKGROUND AND AIMS: Voiding cystourethrography (VCUG) is the first choice imaging modality for assessing the urethra, but this technique exposes patients to ionizing radiation. Cystosonography with echocontrast (CS) has proved to be a reliable technique to detect and grade vesicoureteral reflux (VUR) without exposing patients to ionizing radiation, but its capacity to adequately study the urethra has yet to be demonstrate in large series of patients. The aim of this study is to demonstrate the reliability of contrast-enhanced CS for assessing the urethra by comparing the results with those of the VCUG. MATERIAL AND METHODS: 108 patients were studied with ultrasound (US) using a galactose-based contrast agent. This exam was always followed by VCUG. Basal and voiding urethral US studies were performed with. Patients were studied in supine decubitus position. Girls were examined by longitudinal translabial approach, with the probe (a 7.5 MHz liner array transducer) positioned longitudinally at the introitus, to evaluate the bladder neck and urethra. In boys the transducer was initially placed longitudinally in the escrotum at ventral root of the penis to assess the bladder neck and proximal bulbar urethra, and then displaced distally toward the penile urethra. On basal study the echogenic urethral mucosa and the collapsed sonolucent urethral lumen were indentified and measured when distended. The patients were asked to void with the probe in place. During voiding attention was focused on elasticity and distention of urethral walls, as well as in the caliber of the entire urethra. Patients unable to void during either CS or VCUG were excluded. RESULTS: The bladder neck and the entire urethra were well demonstrate with CS. All females and 43 males showed a normal urethra both in CS and VCUG. Four patients were dignoses of posterior urethral valves (PUV) with CS and confirmed at VCUG, one patient had anterior urethral valves and 5 showed urethral stenosis at both techniques. Three patients with a vesicosphincteric dysinergia, 14 with resected PUV and one with a resected syringocele were adequately evaluated. Twelve girls showed vaginal reflux. The information provided by CS was equivalent to the VCUG in all patients but two with a syringocele (only seen on VCUG). CONCLUSIONS: CS is a reliable imaging modality sufficiently sensitive and specific to study the urethra, adding dynamic information to VCUG and can be used as a complement to VCUG.

Child↗
PubMed2006

What are the supportive structures of the female urethra?

AIMS: Female stress urinary incontinence is thought to result from impairment of the connective tissue "ligaments" of the urethra. Surgical repair of female incontinence mainly involves fixation of the urethra to the pubic bone or other surrounding structures. In the present anatomical-radiological study, the anatomy of the connective tissue structures around the female urethra was investigated to determine the anatomical structures that support the urethra and the rhabdosphincter. MATERIALS AND METHODS: The topography of the anterior compartment of the female pelvis was studied in serial sections and one anatomical preparation of 30 female fetuses and of six adult females. The pelves of 29 female fetuses were processed according to plastination histology technique. The pelves of the six adult specimens were processed according to sheet plastination technique. In addition, the anatomical findings were compared with MR images of 41 adult female volunteers. RESULTS: The ventro-lateral aspect of the urethra remains free of fixating ligaments throughout its pelvic course. Ventro-laterally the urethra is enclosed by the ventral parts of the levator ani, its fasciae and a ventral urethral connective tissue bridge connecting both sides. Dorsally, the urethra is intimately connected to the wall of the vagina. CONCLUSIONS: The female urethra has no direct ligamentous fixation to the pubic bone. Urethral continence after pregnancy and childbirth may be explained by a widening of the hiatus of the levator ani or the anterior vaginal wall, resulting in overstretching of the ventral urethral connective tissue bridge or the disruption of the fixation between urethra and vagina.

Adipose Tissue↗
PubMed1998

The alpha1L-adrenoceptor subtype in the lower urinary tract: a comparison of human urethra and prostate.

OBJECTIVE: To identify the alpha1-adrenoceptor subtypes present in the human urethra, by comparing the affinity of prazosin for alpha1-adrenoceptors in the rabbit, dog and human prostatic urethra, and in the dog and human prostate. MATERIALS AND METHODS: The study comprised samples of human prostate and prostatic urethra, obtained by open prostatectomy of patients with benign prostatic hyperplasia, and of the proximal urethra and prostate from male Beagle dogs and rabbits. Specimens were homogenized, filtered and pelleted by centrifugation. Nonspecific binding was determined in the presence of 1 mmol/L prazosin when assessing [3H]YM-617 (tamsulosin) binding, and 10 mmol/L phentolamine when assessing [3H]prazosin binding. Specific binding was defined as the difference between total binding and nonspecific binding. RESULTS: The dissociation constant for [3H]prazosin in the human prostate (0.088 nmol/L) was less than that in the rabbit urethra (0.299 nmol/L), dog urethra (0.604 nmol/L), dog prostate (0.482 nmol/L) and human urethra (0.254 nmol/L). The affinity of prazosin was also investigated by determining the potency of the inhibition of [3H]YM-617 binding. The affinity of prazosin for alpha1-adrenoceptors in the human urethra (Ki, 2.5 nmol/L) was lower than its affinity for alpha1-adrenoceptors in the human prostate (Ki, 0.25 nmol/L) and all of the cloned subtypes (Ki, 0.26-0.44 nmol/L). CONCLUSION: The alpha1L-adrenoceptor subtype is more prominent in the human, rabbit and dog urethra and dog prostate than in the human prostate.

Adrenergic alpha-Antagonists↗
PubMed1999

Estrogen receptors in the human male prostatic urethra and prostate in prostatic cancer and benign prostatic hyperplasia.

Estrogen receptors (ERs) in the prostate and prostatic urethra were examined in 33 men with benign prostatic hyperplasia (BPH) and in 11 with prostate cancer (PC). The Abbot monoclonal ER-ICA assay was used for immunohistochemical investigation. In the BPH group, ERs were revealed in the prostatic stroma in eight cases and in the glandular epithelium in one. In four cases ERs were seen in the prostatic stroma and in the glandular epithelium. In the prostatic urethra, ERs were found in 19 cases located in the urothelium, lamina propria and/or periurethral glands. In the PC group, ERs were demonstrated in the prostatic stroma and/or prostatic urethra in 6 out of 11 cases. In both BPH and PC patients, immunoreactivity was weak and confined to few cells, indicating low ER content in the prostate as well as in the prostatic urethra. Dextran-coated charcoal (DCC) analysis was used for detection and quanticization of cytosolic and nuclear ERs. In the BPH group, ERs were detected once in the prostate and prostatic urethra in the nuclear and cytosol, and additionally in the prostatic urethra in the cytosol fraction in three cases. In all cases, ER content was low, ranging from 10-15 fmol/mg protein. In the PC group, ERs were detected in the prostatic urethra and/or prostate in the cytosol fraction from two patients. The contents were low, ranging from 10-13 fmol/mg protein. We conclude that in human BPH and PC, ERs can be present in the prostate and prostatic urethra. In the prostate, ERs are mainly located in the stroma, but in BPH specimens they can also be found in the glandular epithelium. Biochemically, the use of the DCC analysis is of limited value, since ER content in the human prostate and prostatic urethra is at the limit of detection with this method.

Adenocarcinoma↗
PubMed2002

Regional differences in the extracellular matrix of the human spongy urethra as evidenced by the composition of glycosaminoglycans.

PURPOSE: Despite the concept that the spongy urethra is a unique entity clinical evidence suggests the existence of segmental structural differences. The spongy urethra has a vascular nature, its cells may express different phenotypes and the extracellular matrix that they synthesize should reflect these differences. Glycosaminoglycans are components of the extracellular matrix that have key roles in the normal physiology and pathology of several tissues. Although total collagen content of the urethra was determined, we also analyzed urethral glycosaminoglycans (GAGs). MATERIALS AND METHODS: Fresh, macroscopically normal cadaveric urethral samples were obtained from 15 men who died at a mean age of 25.4 years. The urethra was divided into glanular, penile and bulbar segments, which were then analyzed separately. Total GAG concentration was assessed by hexuronic acid assay and expressed as microg. hexuronic acid per mg. dry tissue, while the proportions of sulfated GAGs were determined by agarose gel electrophoresis. Hyaluronan concentration was determined by ion exchange chromatography and total tissue collagen was estimated as hydroxyproline content. RESULTS: Total GAG concentration was heterogeneous along the spongy urethra (p <0.001). Mean values plus or minus standard deviation in the glanular, penile and bulbar segments were 2.53 +/- 0.42, 2.11 +/- 0.47 and 1.47 +/- 0.4 microg./mg., respectively. The most predominant GAG was hyaluronan and its highest mean concentration of 50.1% +/- 3.7% was found in the glanular urethra. The most predominant sulfated GAG in the male urethra was dermatan sulfate, followed by chondroitin sulfate and heparan sulfate. Total collagen content and the GAG-to-collagen ratio varied along the spongy urethra and were lowest in the bulbar segment. CONCLUSIONS: The extracellular matrix of the human spongy urethra shows regional differences, as evidenced by biochemical analysis of GAG and collagen. This heterogeneity implies functional adaptations in the various segments and may affect the physiology and segmental incidence of urethral diseases.

Adolescent↗
PubMed2004

The concentration of elastic fibres in the male urethra during human fetal development.

OBJECTIVE: To describe the distribution of elastic fibres in the developing male urethra and to provide stereological data of the concentration of elastic fibres in the human urethra. MATERIALS AND METHODS: Urethras were obtained from 10 fresh normal human fetuses at 15-36 weeks of gestation. A place-matched spongy urethra of a 27-year-old normal adult man was also analysed. Samples were fixed in Bouin's solution, embedded in paraffin and histologically processed. The elastic system fibres were evaluated by light microscopy using Weigert's resorcin-fuchsin technique after oxidation. Morphometric values were assessed by the point-counting method. The volumetric density (Vv) of elastic fibres was correlated with fetal age. RESULTS: At 15 weeks the elastic fibres were sparse and homogeneously distributed. The size and thickness of elastic fibres increased with age, mainly in the third trimester of gestation. Elastic fibres formed a randomly orientated network in the trabeculae of the corpus spongiosum. The mean (sem) Vv of elastic fibres in the spongy urethra was 5.2 (0.4)% in the fetus at 15 weeks and 14.8 (1.0)% at 36 weeks. In the urethra of the place- matched young man the Vv was 19.0 (1.3)%. The concentration of elastic fibres in the spongy urethra increased significantly with age. CONCLUSION: The high concentration of elastic fibres in the spongy urethra may partly explain its high extensibility. The progressive increase in elastic fibres during development implies functional adaptation of the fetal male urethra.

Elastic Tissue↗
PubMed1994

Pharmacological evidence of distinct alpha 1-adrenoceptor subtypes mediating the contraction of human prostatic urethra and peripheral artery.

1. The alpha 1-adrenoceptor subtypes mediating contractions of the smooth muscle in human prostatic urethra and branches of internal iliac artery were characterized in isometric contraction experiments. 2. Phenylephrine produced concentration-dependent contractions in both the urethra and artery. These responses were competitively inhibited by prazosin, WB4101 and 5-methyl-urapidil, and the slopes of Schild plots for all these antagonists were close to unity. 3. The pA2 values for prazosin were not significantly different between the urethra (9.42 +/- 0.11; mean +/- s.d.) and artery (9.50 +/- 0.27), while the pA2 values for WB4101 and 5-methyl-urapidil in the human prostatic urethra (8.94 +/- 0.19 and 8.42 +/- 0.14, respectively) were significantly greater than in the branches of human internal iliac artery (7.94 +/- 0.21 and 7.43 +/- 0.22, respectively; P < 0.01). 4. Pretreatment with chlorethylclonidine (CEC) at concentrations ranging from 0.1 microM to 100 microM attenuated the maximum contraction to phenylephrine in a concentration-dependent manner in both the urethra and artery. However, the urethra was significantly less affected by CEC than the artery. The pD'2 values (negative logarithm of the molar concentration of antagonist which reduced the maximum contraction to one half) in the urethra and artery were 4.35 +/- 0.27 and 5.20 +/- 0.37, respectively (P < 0.01). 5. The present results indicate that there are distinct populations of alpha 1-adrenoceptor subtypes in the human prostatic urethra and branches of the internal iliac artery. The alpha 1-adrenoceptors responsible for the contraction of the human internal iliac artery branches are predominantly alpha 1 B-subtype, whereas those in the human prostatic urethra are considered to be not alpha 1 B, but alpha 1 c or possibly alpha 1 A or alpha 1A/D-subtype.

Aged↗
PubMed2000

Preservation of the thin distal urethra in hypospadias repair.

PURPOSE: We report our experience with preserving the thin distal urethra lacking corpus spongiosum for the treatment of hypospadias. MATERIALS AND METHODS: From January 1997 to October 1999 we treated primary hypospadias in 77 boys with a mean age of 4 years 10 months. After degloving the penile skin a segment of thin distal urethra lacking corpus spongiosum was noted in 18 patients (23.4%) with a mean age of 3 years 5 months. The thin distal urethra was preserved and incorporated as part of urethroplasty (group 1). The procedure was primarily completed by tubularized incised plate urethroplasty. We also performed tubularized incised plate urethroplasty in 31 boys (40.3%) with a mean age of 5 years 2 months who had normal coverage of the corpus spongiosum of a hypospadiac urethra (group 2). We compared the results of treatment in these 2 groups. The remaining 28 patients (36.4%) treated with other methods were excluded from study. RESULTS: In group 1 the distance from the original meatus to the urethra covered by healthy corpus spongiosum was 4 to 20 mm. (mean 8.2). If the thin distal urethra had been excised, the urethral meatus would have been relocated more proximal in these boys. Mean followup in groups 1 and 2 was 9.9 and 7.6 months, respectively. Postoperatively there were 2 (11.1%) urethrocutaneous fistulas in group 1 and 4 (12.9%) in group 2. Tubularized incised plate repair was successful in all 10 cases (100%) of distal hypospadias in group 2, and in 15 of 18 (83.3%) and 17 of 21 (81%) of proximal hypospadias cases in groups 1 and 2, respectively. There was no statistically significant difference in the success rate of hypospadias repair in the groups. CONCLUSIONS: We noted a significantly thin distal urethra in 23.4% of our cases of primary hypospadias. Mean length of the thin distal urethra was 8.2 mm. Preserving the thin distal urethra may simplify the operative procedure without compromising the surgical results of tubularized incised plate urethroplasty.

Adolescent↗
PubMed1983

[A case of an incompletely duplicated ventral urethra].

A ventral incomplete duplicated urethra was found in a 20-year-old male. The accessory urethra lay ventral to and in parallel with the normal urethra. The external orifice of the accessory urethra was also ventral to the orifice of the normal urethra in the glans. On the other hand, the accessory urethra was closed near the bulbar region, and an abscess was found at the dead end. The accessory urethra, which was 9 cm long, was surgically removed. Histopathologically, the luminal surface was covered with a stratified squamous epithelium; and, smooth muscle and spongy tissue were observed around the accessory urethra. The classification of the duplicated urethra is discussed.

Adult↗
PubMed1996

Anatomy and innervation of the rhabdosphincter of the male urethra.

The striated sphincter of the male urethra and its innervation are still a subject of controversy. Essentially, two concepts of its anatomy can be found in the literature. Some authors describe the rhabdosphincter as part of the urogenital diaphragm caudal to the prostate, others as a striated muscle which extends from the base of the bladder to the "urogenital diaphragm." In a combined anatomic-histologic study the striated sphincter and the pudendal nerve were examined by means of anatomical dissections and serial anatomical as well as histological sections of 12 male pelves. Furthermore, radical prostatectomy was performed in a cadaver specimen; subsequently, the so-called "urogenital diaphragm" was excised and then examined histologically. The varying number of striated muscle fibers caudal to the prostate is of particular interest. In fetuses, there are abundant striated muscle fibers dorsal to the membranous urethra, where they are arranged as a circular collar around the urethra. In the adult male, hardly any striated muscle fibers can be found dorsal to the urethra; in a majority of cases this region is devoid of striated muscle fibers. Inserting dorsally in the perineal body, the fibers form an omega-shaped loop around the anterior and lateral aspects of the membranous urethra. The existence of a "urogenital diaphragm" and a strong, circular, striated "external sphincter urethrae" completely encircling the urethra caudal to the apex of the prostate could not be confirmed by our anatomical and histological investigations. Our study shows that the striated muscle fibers run in a cranial direction from the bulb of the penis to the base of the bladder along the anterior and lateral aspects of the prostate and the membranous urethra. Further dissection studies revealed that the rhabdosphincter is supplied by branches of the pudendal nerve after leaving the pudendal canal.

Aged↗
PubMed1995

Different alpha1-adrenoceptor subtypes mediate contraction in rabbit aorta and urethra.

The alpha1-adrenoceptor subtypes mediating contraction of rabbit aorta and urethra were pharmacologically characterized using an isolated organ bath technique. Although aorta was as sensitive as urethra to the contractile action of methoxamine, phenylephrine was about 10 times more potent as a contractile agonist on aorta than on urethra. In aorta, the rank order of agonist sensitivity was norepinephrine > phenylephrine > clonidine > methoxamine whereas the rank order in urethra was clonidine > methoxamine > or = phenylephrine > norepinephrine. A lack of significant correlation between the potency of different alpha1-adrenoceptor antagonists tested against the phenylephrine-induced contraction in aorta and in urethra indicated that different alpha1-adrenoceptor subtypes mediated the contractile response in the two preparations. The potency of different alpha1-adrenoceptor antagonists tested in rabbit urethra was significantly correlated with their affinity for the cloned human alpha1c-, but not alpha1a- or alpha1b-, adrenoceptor subtype. Such a clear correlation with the potency of different alpha1-adrenoceptor antagonists tested in rabbit aorta and their affinity for one subtype of cloned human alpha1-adrenoceptor was not found. Chlorethylclonidine, which produced a 10 000-fold rightward shift in the phenylephrine concentration-response curve for rat aorta, had a weak inhibitory effect in rabbit aorta and urethra as well as in other rabbit tissues (spleen, fundus, renal artery, saphenous artery). The results indicate that significant heterogeneity exists among alpha1-adrenoceptor in rabbit aorta and urethra (alpha1c-adrenoceptor). However, chlorethylclonidine does not seem to be a suitable tool for the differentiation of alpha1-adrenoceptor subtypes in the rabbit.

Animals↗
PubMed2005

The importance of urethra visualization for preplanned permanent prostate implants.

PURPOSE: To assess the potential consequences of using a surrogate urethra on urethral dose estimates in preplanned 125I prostate implants. METHODS AND MATERIALS: For n=220 patients, the A-P and L-R extents of prostate and urethra contours were measured in transrectal ultrasound images. Treatment plans were then developed for 6 patients, of which 5 had atypical urethral positions. For each patient, three plan variations were made using the visualized and two different surrogate urethra contours. RESULTS: The urethra typically remains fixed in the L-R direction and extends slightly below midgland, but may veer off-center and can come within 0.5 cm of the posterior surface of the prostate. Use of a surrogate urethra can potentially result in up to 30% of the urethra receiving doses exceeding a planned limit of 1.5 x 145 Gy over a contiguous length of 2.0 cm. CONCLUSIONS: The urethra should be visualized for preplanning purposes, because unintended urethral doses arising from the use of a surrogate urethra can approach levels associated with late urinary morbidity. Visualization is also essential in the postimplant setting for accurate collection of dose-toxicity data.

Body Burden↗
PubMed2002

Different distribution of nitric oxide synthase and soluble guanylyl cyclase activities in the detrusor and proximal urethra of the rabbit.

PURPOSE: We investigated the different distributions of nitric oxide synthase (NOS) and soluble guanylate cyclase activities in the detrusor and proximal urethra in the rabbit. MATERIALS AND METHODS: The detrusor and proximal urethra were excised, the mucosa and muscularis were separated and each layer was homogenized to measure the activities of NOS as well as baseline and sodium nitroprusside (SNP) activated soluble guanylate cyclase. Isometric tension experiments were performed in detrusor and urethral strips with and without mucosa. RESULTS: In the detrusor NOS and sodium nitroprusside activated soluble guanylate cyclase activities in the mucosa were much higher than in the muscularis. While in the proximal urethra NOS activity in the 2 layers was similar, SNP activated soluble guanylate cyclase activity in the muscularis was 2.8 times higher than in the mucosa. Removing the mucosa reduced nitric oxide (NO) mediated neurogenic relaxation in the proximal urethra, while no relaxation responses could be elicited by electrical field stimulation with or without mucosa in the detrusor. On the other hand, removing the mucosa did not affect SNP or 8-bromo-cyclic guanosine monophosphate induced relaxation in the detrusor and proximal urethra. CONCLUSIONS: In the detrusor NOS and soluble guanylate cyclase activities were mainly detected in the mucosa, while in the urethra these activities were distributed throughout the mucosa and muscularis. Also, the mucosa in the urethra but not in the detrusor contributed to electrical field stimulation induced, NO mediated relaxation. These findings confirm previous studies demonstrating that NO has a different role in the detrusor than in the proximal urethra.

Animals↗
PubMed1991

Development of the human anterior urethra.

To further our understanding of the development of the anterior urethra a series of 38 normal human fetuses ranging from the end of the embryonic period proper to the third trimester of gestation were studied. Tissues prepared as serial histological sections were examined and appropriate specimens were reconstructed. The formation of the bulbar and spongy urethra occurred by proliferation of mesenchyme underlying the epithelium of the urethral folds, causing the creation of a tubular urethra by epithelial fusion in the ventral midline. The tubular urethra becomes invested by mesenchyme, the future corpus spongiosum. This process of fusion of the urethral folds extends to the glans penis. At this period of development the glans contains the urethral plate, a lamina of epithelium lacking a lumen. The mechanism of the subsequent connection of the spongy urethra to the canalized urethral plate has been the point of controversy. Our observations support the idea that 3 processes must act in synchrony to produce successful completion of the anterior urethra: 1) the prepuce forms by overgrowing the glans due to proliferation of the penile skin and subcutaneous tissues, and in so doing it continues the progression of closure of the urethral folds into the glans and forms the frenulum by its fusion on the ventral aspect, 2) the mesenchyme surrounding the prolongation of the urethra fuses with the mesenchyme of the glans, which before this time had existed as a mesenchymal structure distinct from the corpus spongiosum or corpus cavernosum and 3) the epithelium of the urethral plate within the glans, which underlies the epithelial tag, becomes canalized and develops continuity with the lumen of the spongy urethra.

Humans↗
PubMed1989

A histochemical and immunohistochemical study of the autonomic innervation of the lower urinary tract of the female pig. Is the pig a good model for the human bladder and urethra?

The detrusor muscle, bladder neck, proximal, middle and distal regions of the urethra of the female pig were studied by histochemical and immunohistochemical methods to localize catecholamine-containing, acetylcholinesterase-positive and peptide-containing nerves. The peptides examined included: vasoactive intestinal polypeptide, substance P, somatostatin, [Met]enkephalin, bombesin and gastrin. The greatest density of nerves was found in the smooth muscle of the distal urethra, followed by the bladder neck, middle urethra, and proximal urethra, with the least in the detrusor muscle. The greatest number of nerve fibres stained for acetylcholinesterase, followed by vasoactive intestinal polypeptide- and catecholamine-containing fibres. Substance P-immunoreactive nerve fibres were confined to the bladder neck and distal urethral regions. [Met]enkephalin-and gastrin-immunoreactive nerves were most dense in the distal urethra but absent in detrusor muscle, while somatostatin-immunoreactive nerve fibres were sparsely distributed throughout the lower urinary tract. No nerve fibres showing immunoreactivity to bombesin were found. Catecholamine-containing, acetylcholinesterase-positive, vasoactive intestinal polypeptide-, substance P-, [Met]enkephalin- and gastrin-immunoreactive nerves were also found on the adventitial-medial border of blood vessels in the pig urinary tract. In the intrinsic external urethral sphincter, located in the distal urethra, vasoactive intestinal polypeptide- and gastrin-immunoreactive nerve fibres were found bordering a small number of individual striated muscle fibres, while catecholamine-containing nerves were found predominantly in the connective tissue surrounding the striated muscle fibres. Dense populations of acetylcholinesterase-positive nerve fibres were found associated with the striated muscle fibres, with end plates on some of them. Intramural ganglia, composed of two to 30 neurones, were found in the bladder neck and middle and distal regions of the urethra. In the smooth muscle, and in the vicinity of the striated muscle regions of the intrinsic external urethral sphincter, there were small ganglia, containing two to three neurones, which were vasoactive intestinal polypeptide-, [Met]enkephalin- and somatostatin-immunoreactive. The results are compared to the autonomic innervation of the human bladder and urethra as previously described and it is concluded that the lower urinary tract of the pig is a good model for some features of the lower urinary tract of man, but a poor model for others.

Animals↗
PubMed2004

Biomechanical properties of the anterior urethra of the male rabbit--a study using impedance planimetry.

OBJECTIVE: To evaluate the anterior urethra of the male rabbit regarding its luminal cross-sectional area (CSA), CSA distensibility, circumferential tension-strain relation, histology and the collagen content of the tissue. material and methods: Nineteen rabbits were examined with impedance planimetry by distending the urethra at the passage from the spongious to the bulbous part and 1 cm proximally in the bulbous part. Four weeks later, eight rabbits underwent a second examination. After the measurements the urethras were processed for either histology or determination of collagen content. The urethras from six additional rabbits served as controls for histology and collagen content. RESULTS: The CSA and the CSA distensibility were smaller at the distal than the proximal distension site. At both sites the CSA distensibility was high at low luminal pressure loads and decreased with increasing pressure. The circumferential tension-strain plot displayed an exponential relation, with a steeper slope distally than proximally. Repeated biomechanical investigation revealed a significantly increased CSA and a decreased slope of the circumferential tension-strain relation at both distension sites. The biomechanical investigation induced abrasion of the epithelium, extravasation of erythrocytes and separation of the collagen fibres, suggesting oedema of the luminal part of the wall. After 4 weeks the epithelium had changed from transitional to stratified, squamous and often keratinized epithelium and the collagen beneath the epithelium formed a dense network instead of wavy lines as seen in the control urethras. The collagen content was larger at the distal than the proximal distension site. No change in collagen content could be demonstrated between the urethras investigated once or twice with impedance planimetry. CONCLUSIONS: The non-linear pressure-CSA, pressure-CSA distensibility and circumferential tension-strain relations found at both distension sites demonstrate that the urethra yields readily at low pressures, thus facilitating flow. At higher pressure loads, the tissue becomes less distensible, a property that protects it against over-distension and damage. Impedance planimetry cannot be used to study before-and-after phenomena as the biomechanical investigation changed both the histology and the biomechanical properties of the rabbit urethra.

Animals↗