Browsing by Subject "Urethra"
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- PublicationOpen AccessDevelopment of the human foreskin during the fetal period(F. Hernández y Juan F. Madrid. Universidad de Murcia. Departamento de Biología Celular e Histología, 2012) Alves Favorito, Luciano; Balassiano, Carlos Miguel; Silva Costa, Waldemar; Barcellos Sampaio, Francisco JoséAims: Foreskin development begins at twelfth gestational week through a circular invagination of the ectoderm in the glandular periphery that grows ventrally and totally involves the glans around the twentieth gestational week. Studies of foreskin formation chronology and its histological constituents in human fetuses are rare. The objective of this study is to analyze foreskin development during the second trimester of the human fetal period. Methods: We studied twelve well-preserved human fetuses between thirteen and nineteen weeks post conception (WPC), according to the foot length criterion. The fetuses’ weight ranged from 70 to 340 g and the crown-rump length from 11 to 18.5 cm. Their penises were formalin-fixed, paraffin-embedded and cut into 5 micrometers sections. Hematoxylin and eosin, Van Gieson solution, Gomori trichrome and Weigert staining were used. Results: The glans was partially covered by the foreskin in the fetus at 13 WPC and almost completely covered by the foreskin in fetuses at 16 WPC and 17 WPC. The complete foreskin was formed only in the fetuses at 18 and 19 WPC, in which the foreskin totally covered the glans. In all the fetuses studied we observed the presence of preputial lamella and a large amount of mesenchymal tissue between the foreskin and glans. Conclusion: The chronology of foreskin formation in the second gestational trimester is well documented in our article. It is a fast process that lasts around five weeks and is coordinated with penile urethra formation
- PublicationOpen AccessHistological and morphometrical evaluation of the urethral wall after bioresorbable stent implantation in male New Zealand White Rabbits: A preliminary study(Universidad de Murcia. Departamento de Biología Celular e Histología, 2024) Skonieczna-Kurpiel, Joanna; Madej, Jan P.; Klekiel, Tomasz; Mackiewicz, Agnieszka; Będziński, Romuald; Noszczyk-Nowak, Agnieszka; Piasecki, TomaszThe aim of the study was the histological and morphometrical evaluation of the urethral wall at three time points after bioresorbable stent implantation in male New Zealand White Rabbits. The research was performed on 26 male New Zealand White rabbits aged 3-4 months and weighing 2.1-3.0 kg. Two models of bioresorbable sodium alginate-based stents were developed and implanted into the urethral lumen for one (T1), three (T3), and six weeks (T6). Sections of 5 µm thickness were cut from the urethra at intervals of 2 mm. The sliced sections were stained with hematoxylin-eosin (H&E), Van Gieson's (VG), Von Kossa, and Movat– Russell modified pentachrome (MOVAT) staining methods. The study provided valuable information for future models of urethral stents. The first model of the stent failed to fit the requirements due to inadequate mechanical properties. It curled up on itself losing the ability to adhere to the animals’ urethra and was bioresorbed three weeks after implantation. The more rigid no. 2 stent was effective in widening the urethral lumen but did not biodegrade during the experiment. A comprehensive assessment of the second model’s properties of biosorption and biointegration requires an extended observation of at least 12 months for an in depth morphological analysis. Stent migration is not likely to be caused solely by the mechanical properties of the urethra or urinary flow but mainly by muscle contraction of the organ wall.
- PublicationOpen AccessInnervation of the proximal urethra of ovariectomized and estrogen-treated female rats(Murcia : F. Hernández, 2004) Smith, P.G.; Bradshaw, S.The proximal urethra plays a central role in maintaining urinary continence, and sympathetic excitatory innervation to urethral smooth muscle is a major factor in promoting tonic contraction of this organ. Elevated estrogen levels are often associated with incontinence in humans. Because elevated estrogen levels result in degeneration of sympathetic nerves from the closely related uterine smooth muscle, we examined the effects of chronic estrogen administration on proximal urethral innervation. Ovariectomized virgin female rats received either vehicle or 17 ß-estradiol for 1 week, and smooth muscle size and parasympathetic, sensory and sympathetic nerve densities were assessed quantitatively throughout the first 3 mm of the proximal urethral smooth muscle. In vehicle-infused ovariectomized rats, parasympathetic nerves immunoreactive for vesicular acetylcholine transporter were most abundant, while calcitonin gene-related peptide-immunoreactive sensory nerves and tyrosine hydroxylase-immunoreactive sympathetic nerves were less numerous. The densities of parasympathetic and sensory nerves remained constant along the proximal urethra, while sympathetic nerves showed a significant increase along a proximal-distal gradient. Administration of 17ß-estradiol for 7 days via subcutaneous osmotic pump did not change smooth muscle area in sections, and neither densities nor total innervation of any nerve population was altered. These findings reveal a rich cholinergic innervation of the proximal urethra, and a pronounced gradient in sympathetic innervation. Unlike the embryologically similar uterine smooth muscle, estrogen does not influence muscle size or composition of innervation, indicating that estrogen’s actions on innervation are highly target-specific. Thus, estrogen’s effects on urinary continence apparently occur independently of any significant remodeling of smooth muscle or resident innervation.
- PublicationRestrictedOptimisation of sonourethrography: the clamp method(Springer, 2018-05-01) Berná Mestre, Juan de Dios; Balmaceda, Thierry; Martinez, Diego; Escudero, José F.; Martínez, Gloria; García, José A.; Canteras, Manuel; Berná Serna, Juan De Dios; Dermatología, Estomatología, Radiología y Medicina FísicaTo describe the clamp method for performing retrograde sonourethrography (RSUG) and contrast-enhanced voiding sonourethrography (CE-VSUG) via the transperineal approach in male adults. Prospective study of 113 males (14-86 years) with urethral strictures confirmed by urethrography who received sonourethrography via the clamp method between 2011 and 2015. The characteristic parameters of the quantitative variables were calculated and a comparative analysis of the qualitative variables was conducted using the McNemar test. RSUG was performed successfully in all the cases (n = 113) and detected 49 cases with anterior urethral strictures; the strictures in the proximal bulbar cone in five of them (10.2%) were not visualised on retrograde urethrography (RUG) (p < 0.05). CE-VSUG was performed successfully in 97 cases and observed posterior urethral strictures in 82; the bladder neck strictures in 6 of them (7.3%) were not observed on voiding cystourethrography (VCUG) (p < 0.05). Retrograde bladder filling was achieved in approximately 6 min. The clamp method enables RSUG and CE-VSUG to be performed simply, effectively and painlessly by a single operator. It also allows the evaluation of cases with urethromeatal alterations (stricture, hypospadias and meatotomy).
- PublicationOpen AccessThe multilayered structure of the human corpus spongiosum(2018) De Graaf, P.; Ramadan, R.; Linssen, E.C.; Staller, N.A.; Hendrickx, A.P.A.; Pigot, G.L.S.; Meuleman, E.J.H.; Bouman, M.; Özer, M.; Bosch, J.L.H.R.; de Kort, L.M.O.Purpose. Urethral reconstruction is performed in patients with urethral strictures or for correction of congenital disorders. In the case of shortage of tissue, engineered tissue may enhance urethral reconstruction. As the corpus spongiosum (CS) is important in supporting the function of the urethra, tissue engineering of the urethra should be combined with reconstruction of a CS. For that purpose, detailed knowledge of the composition of the CS, more specifically its extracellular matrix (ECM) and vascularization is needed for scaffold design. The objective of this study is to analyze the microarchitecture of the CS through (immuno) histology and scanning electron microscopy (SEM). Methods. The CS including the urethra of patients undergoing male-to-female genital confirming surgery was harvested. This CS was fixed and processed for either (immuno) histology or for SEM. Results. Four layers could be distinguished in the CS; first a transition zone from urethra epithelium to a collagen rich layer, which was highly vascularized, followed by a second, elastin rich layer. The third layer was formed by veins, arteries and vascular spaces and the last layer showed the transition from this vascular rich region to the collagen rich tunica albuginea. In this layer collagen bundles intertwined with elastic fibres. In the CS different components of the ECM were visible and distinguishable. Conclusion. This study provides novel and detailed information on the microarchitecture of the CS and the distribution of vascularization, which is important for scaffold design in tissue engineering.
- PublicationEmbargoUrethrography in Men: Conventional Technique versus Clamp Method(Radiological Society of North America, 2009-07-01) Berná Mestre, Juan de Dios; Aparicio Mesón, Martín; Canteras Jordana, Manuel; Berná Serna, Juan De Dios; Dermatología, Estomatología, Radiología y Medicina FísicaTo compare examination adequacy and patient discomfort during retrograde urethrography (RUG) performed by using the conventional balloon method versus those of RUG and voiding cystourethrography (VCUG) performed with he clamp method of using drip infusion for the administration of contrast material. Materials and Methods: This prospective study was approved by the institutional review board; written informed consent was obtained from all patients. Eighty men (mean age, 64.3 years; range, 18 – 85 years) suspected of having urethral stenosis were randomly distributed into two groups for urethrography: a control group (n 36) and a clamp group (n 44). In 11 of the 36 patients in the control group, the conventional balloon method could not be used, so these patients were transferred to the clamp group. Drip infusion was used to administer contrast material for RUG, and, except in cases where a suprapubic catheter was used (n 8), for VCUG. The pain levels reported by patients were recorded by using a verbal descriptor scale (VDS) and a visual analogue scale (VAS). Results: In the control group, RUG was successfully performed in 69% of patients (25 of 36), and mean pain levels recorded on inflation of the balloon were distressing according to the VDS and 4.8 (range, 2.3–7.5) according to the VAS. In the clamp group, RUG was successfully performed in all cases; in 69% of patients in this group (38 of 55), the pain level recorded at external compression was no pain according to the VDS and 0 according to the VAS, while mean values in the remaining 31% of patients (17 of 55) were mild pain on the VDS and 0.6 (range, 0.3–1.2) on the VAS. Bladder filling for VCUG was achieved with drip infusion in 96% of patients (69 of 72) in an average time of 11 minutes. Conclusion: The conventional balloon method of performing RUG is painful and, in some cases, not effective. The clamp method is a simple, well-tolerated procedure that allowed diagnostic evaluation in all cases. Drip infusion enables RUG and VCUG to be performed without the need for syringes or bladder catheters, thus increasing patient comfort.