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Basic medicine: physiology
Published in Roy Palmer, Diana Wetherill, Medicine for Lawyers, 2020
Urine is collected into the renal pelvis on each side, which in turn is connected by means of a long tube (the ureter) to the bladder. The function of the bladder is to store urine until a convenient moment for micturition (voiding), and then to expel the urine via the urethra by contraction of the powerful muscle in its wall. As with defaecation, this process requires relaxation of the normal sphincter mechanism that guards against incontinence. Micturition is under the influence of the autonomic nervous system, with an over-riding control by the cerebral cortex.
The Urinary System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
The urinary bladder is a distensible, muscular sacm the pelvis. When empty, the bladder's walls collapse; as it fills, it expands upward. Covered at the top by peritoneum, the bladder is separated from the rectum posteriorly by the rectovesical pouch in the male and from the uterus by the vesicouterine pouch in the female. The internal floor of the bladder forms a smooth triangular area known as the urethral trigone (trigonon is Greek for "triangle"). At the posterolateral angles of the trigone, the ureters enter at the uretic orifices; at the front angle is the internal urethral orifice through which the urethra leaves the bladder. The detrusor uniae muscles, the muscles of the bladder, stretch when the bladder fills and contract in response to relaxation of the urethral sphincter to empty the contents.
Management of deep infiltrative endometriosis (DIE) causing gynecological morbidity: A urologist's perspective
Published in Seema Chopra, Endometriosis, 2020
Aditya Prakash Sharma, Girdhar Singh Bora
The most prevalent symptoms of DIE include dysmenorrhea, dyspareunia, and pelvic pain [17–19]. Lower urinary tract symptoms (LUTS) have been variably reported, ranging from 2% to 77% [20–22]. Panel et al. found no difference in the rate of LUTS (urgency, frequency, and pain in bladder) between patients with posterior endometriosis with or without bladder endometriosis (BE) [22]. Symptoms specific to BE include dysuria, frequency, bladder pain, hematuria, urgency, and urinary incontinence [3,4,23,24]. Dysuria is found in 21%–69% of patients with BE [3,4,24]. The severity of dysuria depends upon the size of the lesion [38]. Bladder lesions rarely infiltrate the mucosa, and thus, cyclical hematuria, although classical, is found less commonly, ranging from 0% to 35% in various series [3,4].
Comprehensive overview of the venous disorder known as pelvic congestion syndrome
Published in Annals of Medicine, 2022
Kamil Bałabuszek, Michał Toborek, Radosław Pietura
Because the pelvic veins form a network around the organs and many connections are present between the veins draining different pelvic regions patients with PVI often present with atypical varicose veins of the upper inner and back thigh of the lower limb and vulvovaginal, glutaeal, suprapubic perineal varices [19] (Figures 3 and 4). The prevalence of vulvar varices in patients with PCS is as high as 24–40% [51,52] (Figure 3). When the pelvic inflow is not treated, the varicose veins managed surgically often return [19]. In up to 80% of patients with pelvic venous dilatation different degrees of associated lower limb venous insufficiency can be observed [53,54]. The frequency of reporting leg symptoms such as pain, edoema, heaviness increases with age [50]. PCS is also suspected as a cause of venous leg ulcers and infertility [55,56]. In the course of the PCS, urinary symptoms may occur due to perivesical varicosities such as bladder irritability and urgency or dysuria. PCS can also mimic mons pubis abscess or osteoarthritis of the hip [57,58]. Other manifestations of PCS may also include headache, dysmenorrhoea, lumbosacral neuropathy, leg heaviness, rectal discomfort, swollen vulva, vaginal discharge, persistent genital arousal and non-specific gastrointestinal symptoms such as bloating and nausea [10,12,14,26,39,49].
Current status of the development of intravesical drug delivery systems for the treatment of bladder cancer
Published in Expert Opinion on Drug Delivery, 2020
Ho Yub Yoon, Hee Mang Yang, Chang Hyun Kim, Yoon Tae Goo, Myung Joo Kang, Sangkil Lee, Young Wook Choi
The urinary bladder is a spherically shaped hollow organ; its basic function is the short-term storage of urine. The volume of urine in the bladder is affected by several factors such as gender, ethnicity, and race; however, the average volume is approximately 400–600 mL [22]. However, the presence of approximately 150 to 200 mL of urine in the bladder triggers the first sensation of urination, which is regulated by the myovesical plexus within the bladder that sends the voiding signal to the detrusor muscle, which regulates the extent and frequency of voiding [21]. Although IDD offers the advantage of delivering a large amount of instilled drug at the tumor site in the bladder without an increase in systemic blood levels, the bladder is constantly filled with urine, which eventually dilutes the drug. As illustrated in Figure 1, the periodic voiding of urine washes out the instilled drugs, resulting in a reduced duration of action and, consequently, the need for frequent dosing.
Hysteropexy with single-incision vaginal support system associated with a modified culdoplasty for enterocele prevention
Published in Journal of Obstetrics and Gynaecology, 2020
Giuseppe Ettore, Gabriella Torrisi, Carla Ettore, Vincenzo Guardabasso
The urinary symptoms related to bladder filling improved in some patients. However, eight patients (17%) developed de novo UI, including six cases of stress-UI and two cases of urge-UI. Therefore, no significant difference was observed after the surgery (Table 2). Voiding dysfunctions disappeared. Complications are listed in Table 3. No organ injury or other major complications (CD grade IIIb or above) occurred. Minor complications occurred in seven patients (15%, 7/48) (Table 3). Three patients had vaginal extrusion of the mesh (6%, CD grade IIIa) and underwent surgical correction under local anaesthesia involving excision of the exposed mesh and adjustment of the epithelial layer. Pelvic pain was reported by four patients (8%, CD grade I), with resolution of symptoms a few months after the surgery in all cases.