Microvascularisation of the male urethra in neonates and infants

The microvascularisation of the male urethra was studied in neonates and infants by injection of agarised China ink into the circulation. The purpose of this study was to specify the angioarchitecture of each tunic of the urethral wall. The disposition of the microvascularisation networks varies depending on the urethral parts considered: only the mucous membrane networks are uniform throughout the entire urethra. The sub-mucous networks are significantly increased in the spongy part. The muscular networks disappear in the spongy part.     

化学去细胞尿道在大鼠皮下的埋置

背景：有研究提出了移植排斥反应的实质是受者免疫系统对供者移植物抗原的免疫应答反应。 目的：验证化学萃取去细胞处理对同种异体尿道移植抗原性的影响。 方法：取SD大鼠尿道共20根,每段长1 cm。其中10根采用化学去细胞法处理大鼠尿道的免疫原性成分,使其成为去细胞尿道;另外10根不做去细胞处理为新鲜尿道。在10只Wistar大鼠背部皮下植入去细胞尿道,另取10只大鼠背部皮下植入新鲜同种异体尿道。6周后取材行大体和组织学检查。 结果与结论：20只Wistar大鼠在皮下埋植尿道后均无自嗜肢体现象,切口愈合良好,饮食正常,无溃疡发生。6周后取材大体观察可见去细胞尿道周围有组织膜形成,而新鲜尿道未见组织膜形成。苏木精-伊红染色可见去细胞尿道逐渐被吸收,被平滑肌组织取代,并可见大小不等血管长入去细胞尿道内,部分有形成血窦的倾向;对照组尿道未见吸收,未见血管长入。提示化学去细胞尿道在大鼠体内逐渐形成类似正常尿道的组织材料,说明化学去细胞同种异体尿道移植的抗原性明显降低,可替代正常尿道海绵体组织。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程全文链接：     

‘Elastic length’ of the female urethra—initial measurements

An elasticity parameter known as the elastic length of the urethra was derived from a theory of flow presented in a previous article. The suggestion was made that a consideration of this parameter could be relevant to an understanding of the flow of urine through the urethra. The present short paper presents an account of initial measurements of the elastic length for two females. It seems likely that we cannot neglect the elastic length when considering flow through the urethra.     

Ciliated epithelia in the urethra: case report and literature review

The presence of ciliated epithelial cells in the urethra has not been well recognized. Only two reports in the literature, both of which used scanning microscopy studies, have described this phenomenon. In this report, we illustrate the presence of scattered, ciliated epithelial cells in penile urethral biopsy specimens from a 38-year-old man with a history of bladder calculi and hematuria, by both light and transmission electron microscopy studies. The cilia in the urethra showed typical light microscopic and ultrastructural features of those seen in other organs. These ciliated cells are present in association with urothelial papilloma, condyloma acuminatum and acute inflammation of the urethra. These findings suggest that ciliated cells in the penile 0 urethra might be a consequence of metaplastic change of the urothelium, secondary to local stimulation or irritation.     

女性尿道括约肌支配神经的应用解剖

目的:为根治性膀胱切除手术中保护尿道控尿神经提供解剖学依据。方法:通过对14例成年女性尸体盆腔标本全面的神经解剖学研究,观察女性尿道控尿神经的走向、组成、形态及其毗邻关系。结果:控尿神经是由下腹下丛和阴部神经盆内盆外分支组成,其中盆神经是下腹下丛远端盆内脏神经分支,沿肛提肌表面到达尿道5点和7点位。71.4%的标本中发现阴部神经存在盆内分支,此分支自阴部管内的阴部神经主干穿肛提肌进入盆内,大约在接近尿道括约肌时汇入盆神经共同进入尿道括约肌,其进入尿道的位置距离膀胱颈平面(12.6±1.6)m m。另外在42.9%的标本中阴蒂背神经发出分支到达尿道,此分支进入尿道的位置距离膀胱颈平面(21.6±1.9)m m。结论:女性尿道的控尿神经是由盆神经和阴部神经的盆内盆外分支组成。在根治性膀胱切除手术中,膀胱颈平面以下尿道周围的操作易损伤控尿神经。     

尿道前列腺型息肉1例并文献复习

目的:探讨尿道前列腺型息肉的临床病理学特点、诊断及鉴别诊断.方法:收集天津市武清区人民医院诊治的尿道前列腺型息肉l例,收集患者详细的临床资料、实验室检查、病理检查资料、患者的治疗及随访情况,结合文献进行分析.结果:患者,33岁,男性,右侧腰腹部间断疼痛2年.泌尿系超声检查示:右肾盂积水,右输尿管结石.经输尿管钬激光碎石术中发现尿道前列腺部有直径5 mm的息肉一枚.镜下可见肿物被覆两种上皮,为无异型的前列腺型上皮和移行上皮.腺上皮形成腺泡状和乳头状结构,细胞排列为两层.免疫组织化学示基底层细胞胞核表达p63,分泌层细胞胞浆表达PSA,两种细胞均未表达P504s和Ki-67.结合病史、辅助检查及病理组织学,最终诊断为尿道前列腺型息肉.患者经碎石及息肉切除后痊愈,随访2年无复发.结论:尿道前列腺型息肉少见,正确诊断对治疗有重要指导意义.组织学形态需注意与表现为尿道息肉的前列腺导管腺癌等鉴别.诊断需结合病史、临床症状、内镜下表现、组织学及免疫组织化学检查等综合分析.     

男性尿道膜部括约肌支配神经的应用解剖

目的:为根治性膀胱前列腺切除手术中保护尿道控尿神经提供解剖学依据。方法:对15例成年男性尸体盆腔标本进行解剖,观察支配尿道膜部括约肌神经的组成、形态及毗邻关系。结果:尿道膜部括约肌接受下腹下丛和阴部神经盆内盆外分支支配,其中盆神经起源于下腹下丛远端盆内脏神经分支,沿肛提肌表面到达尿道膜部5点和7点位;40%的标本中阴部神经存在盆内分支,此分支自阴部管内的阴部神经主干穿肛提肌进入盆内,与盆神经一起支配尿道膜部括约肌,其进入尿道膜部的位置距离前列腺尖部(5.3±1.8)mm。在53.3%的标本中阴茎背神经发出分支到达尿道膜部,此分支进入尿道膜部的位置距离前列腺尖部(4.2±1.1)mm。结论:根治性膀胱前列腺切除术中对控尿神经的保护是多方面的,术中对精囊和前列腺尖部的操作最易损伤控尿神经。     

Mucinous adenocarcinoma of posterior urethra. Report of a case

Primary carcinoma of the male urethra accounts for less than 1% of malignancies in males. Mucinous adenocarcinoma of the urethra is extremely rare, and its biologic behavior is not well known. We report a case of mucinous adenocarcinoma showing the histologic features of colloid adenocarcinoma that appears to have evolved either by neoplastic degeneration of goblet cells found in the urethral epithelium or by malignant degeneration of persistent glandular elements of uretheritis cystica and glandularis.     

三种手术入路显露尿道膜部的比较解剖学研究及临床应用

目的:评价经耻骨上、耻骨下及会阴三种手术入路暴露尿道膜部的优劣,并探讨耻骨下部分切除入路治疗复杂性后尿道狭窄的应用。方法:35例成年男性尸体标本解剖后测量耻骨联合上缘(A)、下缘(B)及会阴部两坐骨结节连线上缘中点(C)距尿道球膜部交界处(D)、前列腺尖(E)连线距离及其相关角度;复杂性后尿道狭窄8例,全部采用耻骨下部分切除入路治疗。结果:AD=(6.5±0.5)cm,BD=(2.2±0.5)cm,CD=(3.4±0.6)cm,BD相似文献   

Regional distribution of α-adrenoceptor subtypes in the female rabbit urethra

The aim of the present investigation was to study the regional distribution of α-adrenoceptor subtypes in the female rabbit bladder base and urethra, using radioligand binding and mechanical activity studies. The binding studies performed on membranes prepared from the bladder base, and the proximal and distal part of the urethra, revealed that the number of α₁-adrenoceptors did not significantly differ between the three regions, whereas the number of α₂-adrenoceptors increased distally. The mechanical activity studies showed that noradrenaline and clonidine, but not phenylephrine, were more potent in the distal than the proximal part of the urethra. It is suggested that in the female rabbit urethra the lower EC₅₀-value found for noradrenaline and clonidine in the distal as compared to the proximal part of the urethra, at least in part, is attributable to a higher number of postjunctional α₂-adrenoceptors in the distal than in the proximal urethra.     

Influence of antimuscarinics on alpha-adrenoceptors in the female rabbit urethra

The effects of the tertiary amine atropine and its structural analogues homatropine and scopolamine, as well as the quarternary amine emeprone, were evaluated on noradrenaline (NA)-induced contractions of isolated female rabbit urethral ring preparations. In addition, the abilities of these antimuscarinics to inhibit ³H—dihydro—alpha—ergocryptine (³H—DHE) binding to alpha—adrenoceptors were studied on a crude membrane preparation from the female rabbit bladder base and urethra. Atropine and homatropine depressed the NA- induced contractions in a concentration-dependent way, whereas this was not seen with scopolamine. Emeprone 10^-5 10^-4 M augmented the contractions, an effect possibly attributable to a NA-uptake blocking effect. All antimuscarinics displaced specific ³H— DHE binding, the order of potency being atropine>homatropine>emeprone>scopolamine. In general a good correlation was seen between the binding and mechanical activity studies for atropine, homatropine and scopolamine, while this was not found for emeprone. It is concluded that alpha-adrenoceptor blockade by atropine can be observed at concentrations exceeding 10^-7 M. Scopolamine, showing alpha-adrenoceptor blocking properties only in high concentrations, may be used as an alternative for blockade of muscarinic cholinoceptors.     

Clear cell adenocarcinoma and nephrogenic adenoma of the urethra and urinary bladder: A histopathologic and immunohistochemical comparison

Because of histological similarities between nephrogenic adenomas and clear cell adenocarcinomas of the urinary tract, there is the potential for diagnostic confusion between these two entities. The histopathologic features of 13 nephrogenic adenomas and five clear cell adenocarcinomas of the urethra and urinary bladder are compared in this report, and detailed immunohistochemical staining profiles are provided for these tumors. Only 2 of the 13 nephrogenic adenomas contained clear cells, and these constituted less than 10% of the lesions. In contrast, four of the five clear cell adenocarcinomas contained prominent areas with clear cells. Nephrogenic adenomas generally showed only mild cytologic atypia, whereas four of the five clear cell adenocarcinomas showed severe atypia. A single mitotic figure was identified in only two of the nephrogenic adenomas, whereas the mitotic rate in the clear cell adenocarcinomas ranged from 2 to 14 per 10 high-power fields. None of the nephrogenic adenomas showed evidence of necrosis, but focal necrosis was noted in four of the five clear cell adenocarcinomas. In general, the nephrogenic adenomas and clear cell adenocarcinomas showed negative to weak staining with CK903 but strong staining with AE1, AE3, and Cam 5.2. Variable staining was observed with Brst-3 and antibodies to S-100, CEA (monoclonal and polyclonal), LeuM-1, and CA19.9. Nephrogenic adenomas and dear cell adenocarcinomas were all negative for prostate-specific acid phosphatase (PSAP), prostate-specific antigen (PSA), and estrogen and progesterone receptors (except for two nephrogenic adenomas, which showed only focal weak staining for estrogen receptor). Neither bcl-2 nor c-erbB-2 staining was able to discriminate between the tumors. However, strong staining for p53 was noted in each clear cell adenocarcinoma and in none of the nephrogenic adenomas. MIB-1 positivity in nephrogenic adenomas ranged from 0 to 13 (average of 5.5) per 200 cells, whereas the positive range for clear cell adenocarcinomas was 33 to 70 (average of 47) per 200 cells. In summary, histopathologic features that favor clear cell adenocarcinoma over nephrogenic adenoma include a predominance of clear cells, severe cytological atypia, high mitotic rate, necrosis, high MIB-1 positivity, and strong staining for p53.     

Model of counter-current transfer from vagina to urethra in postmenopausal women.

BACKGROUND: Low-dose vaginal oestrogens are effective in treating post-menopausal urogenital atrophy without inducing endometrial proliferation. We aimed to assess whether this dichotomic effect could be the result of a preferential vagina-to-urethra transfer via a counter-current transfer of oestrogens from vagina to the arterial blood supplying the urethra. Due to the impossibility of obtaining blood samples from urethral arteries, and since the nature of counter-current exchange of substances is similar to the transfer of heat, we investigated cold transfer throughout the anterior vaginal wall to the vesical trigone and urethra. METHODS: Plastic tubes filled with cold saline were inserted into the vagina of 30 menopausal women. Temperatures were recorded at the vesical trigone and at three different urethral sites. Comparisons were performed 2 and 4.5 min after starting of cooling, and 4.5 min after removal of tubes. RESULTS: The urethra cooled significantly more than the bladder. Urethral cooling was not homogeneous; distal sites of the urethra cooled significantly more than proximal site and bladder despite a larger distance to the vaginal cooling device. CONCLUSIONS: Distribution of cold from the vagina to the urethra is not the result of simple diffusion and mechanisms of preferential distribution may exist from the vagina to the middle and low part of the urethra.     

带血管神经蒂股薄肌瓣重建尿道括约肌的应用解剖

目的为带血管神经蒂股薄肌瓣转位重建尿道括约肌术提供解剖学基础。方法在35例成人下肢标本上,对股薄肌的形态、主要血管、神经的来源,血管神经蒂的长度、入肌部位等进行解剖观测。结果股薄肌全长(42.0±0.6)cm,肌腹长(31.0±3.8)cm;肌腱长(10.9±0.9)cm;股薄肌的血供主要来源于股深动脉的股薄肌支,该分支起始处外径(2.1±0.6)mm,血管蒂长(9.2±0.9)cm,入肌部位在股薄肌中、上1/3交界处前缘的深面;股薄肌的神经支配,均恒定地来自闭孔神经前支,该神经在闭膜管处,横径为(1.7±0.4)mm;厚(0.5±0.2)mm,从闭膜管至入肌点处长(10.4±1.4)cm。结论带血管神经蒂股薄肌瓣转位重建尿道括约肌术,经尸体摹拟实验,证明具有可行性。     

The endocrine-paracrine cells of von Brunn''s nests and glandular metaplasia in the supramontanal prostatic urethra

Endocrine-paracrine (EP) cells are normal cellular constituents of the human genitourinary tract. We examined the distribution and immunostaining profile of EP cells in von Brunn's nests and glandular metaplasia in the supramontanal (proximal) prostatic urethra of adult males and in prostatic ducts of the male fetal urethra. In 15/17 transurethral prostatic resection specimens there were argyrophilic cells and/or serotonin and neuronspecific enolase containing cells in von Brunn's nests/glandular metaplasia and in the supramontanal prostatic urethra. All seven fetal specimens examined contained EP cells and five had focal calcitonin immunoreactivity in prostatic ducts and ductal buds. One adult resection specimen had focal staining for human chorionic gonadotrophin and no case showed staining for somatostatin. These results further support the contention that von Brunn's nests and glandular metaplasia are probably normal urothelial variants in the adult supramontanal prostatic urethra.     

Tissue elasticity and the dynamics of flow through the urethra in females

A theoretical model of flow through the female urethra is developed, taking account of longitudinal tension in the urethral wall. An elasticity parameter which has the dimension of length appears and is being termed the ‘elastic length’ L of the urethra. This parameter and the spread of the pressure profile produced by the tissue surrounding the urethral wall are important factors in the control of the rate of flow. Because of this, the possibility exists that flow will take place for a bladder pressure below the maximum tissue pressure.