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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.
Genitalia
Published in Shiv Shanker Pareek, The Pictorial Atlas of Common Genito-Urinary Medicine, 2018
Urethra – this starts from the internal urethral orifice in the urinary bladder and runs to the external urethral opening at the glans penis. It is divided into three parts: the prostatic urethra, the membranous urethra, and the spongy urethra (also called the penile urethra). The total length of the male urethra is 175 mm to 200 mm. The urethra has two main functions: to allow urine to empty from the bladder and to allow the flow of semen during ejaculation.
Imaging of the Upper and Lower Urinary Tract: Radiology and Ultrasound
Published in Linda Cardozo, Staskin David, Textbook of Female Urology and Urogynecology - Two-Volume Set, 2017
Andrea Tubaro, Kirsten Kluivers, Federica Puccini, Antonio Carbone
Also vAries with pelvic inclinAtion, Although cutoff vAlues of <45° or >45° hAve been described [3]. The Angle between A line through the middle of the internAl urethrAl orifice And the urethrAl knee And A line through the posterior surfAce of the symphysis And the lowermost pArt of the obturAtor forAmen closest to the film is defined As the urethropelvic Angle (vAlues of 95° Are meAsured in controls And A cutoff vAlue of 70° hAs been proposed to diAgnose blAdder descent) [61]. The symphysis orifice (so) distAnce is meAsured At rest As the distAnce on A horizontAl line from the symphysis to the internAl urethrAl orifice (normAl vAlues Are 31 mm And vAlues <20 mm Are the cutoff points for descent And were used to diAgnose Anterior blAdder suspension defects or blAdder bAse insufficiency) [61,66]. In continent women, the urethrAl Axis At rest (uAr) wAs found to be relAted to Age (r 2 = 0.28); pAtients with UI hAd A meAn uAr of 25° And
Investigation of pelvic floor disorders
Published in Climacteric, 2019
For the evaluation of patients with SUI, Tunn et al.27 recommended measurement of the retrovesical angle and the position of the internal urethral orifice using transperineal ultrasound. The qualitative parameters to be determined are the position and mobility of the urethra (fixed, hypermobile), the bladder base (vertical, rotational, or no descent), and funneling of the bladder neck. Measurements of bladder neck position are performed at rest and on maximal Valsalva maneuver, and the difference yields a numerical value for bladder neck descent. There is no definition of ‘normal’ for bladder neck descent, although Dietz28 proposed a cut-off point of <30 mm for young nulligravid continent women. In patients with SUI, but sometimes also in asymptomatic women, funneling of the internal urethral meatus (a sonographic-only sign) may be observed on Valsalva maneuver and occasionally even at rest29. Marked funneling has been shown to be associated with poor urethral closure pressure, a urodynamic parameter which has been associated with poor outcomes following anti-incontinence surgery.
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
Although the in-situ hydrogel is a promising option for prolonged residence time in the bladder, a major limitation of this formulation is the possibility of urinary obstruction owing to the high viscosity of hydrogels. Gels that adhere to the bladder wall could block the urinary tract, including the internal urethral orifice. In addition, as hydrogels are generally designed to adhere to the bladder wall, they can cause bladder irritation. Therefore, the concept of a floating hydrogel was developed to overcome this shortcoming [57,83,85]. However, to date, there are limited studies in the literature that deal with floating agents to drive a floating force; thus, extensive research is encouraged in this area.
Ultrasound analysis of the effect of second delivery on pelvic floor function in Chinese women
Published in Journal of Obstetrics and Gynaecology, 2022
Xiao-Hui Shao, De-Jiao Kong, Li-Wei Zhang, Lu-Lu Wang, Si-Ming Wang, Li-Juan Yu, Xiao-Qiu Dong
The researchers who performed the ultrasound imaging were aware of 4 groups, but did not know the specific situation and actual group the participant belonged to while taking ultrasound measurements on each participant. The 3D transducer was first coated with a sterile coupling agent, then covered with a special sterile transducer cover before another layer of sterile coupling agent was applied. Then, the transducer was placed firmly against the subject’s perineum to display the standard median sagittal view of the pelvic floor, where the internal urethral orifice, bladder residual urine volume, detrusor thickness, urethral tilt angle, and retrovesical angle were observed in the resting and maximum Valsalva manoeuvre states with researchers’ reminds and accompany. The horizontal reference line that is much easier to be drawn as it does not depend on visualisation of the full contours of the interpubic disc proposed by Dietz (touching the lower border of the symphysis pubis, drawn parallel to lower border of screen) (Dietz and Wilson 1998) was used to determine the following: (1) a cystocele (the lowest point of the posterior wall of the bladder was below the reference line with or without opening of the retrovesical angle and an increase in the urethral tilt angle; (2) uterine and/or vaginal prolapse (if the cervix or prolapse was located below or 0–15 mm above the reference line); and (3) a rectocele or perineum descent (the anterior wall of the rectal ampulla bulged towards the vagina and the lowest point was below the reference line or the entire rectal ampulla was below the reference line and the distance between the lowest point and the reference line was >15 mm) (Zhang 2013; Hennemann et al. 2014; Najjari et al. 2014). The 3D images were acquired in the resting and maximum Valsalva manoeuvre states, from which sagittal, coronal, and axial views, as well as 3D-rendered volume images, were constructed. When quality 3D-rendered images were obtained through adjustments in the X and Y planes, the levator hiatus parameters, including the levator hiatus area (the area of the hiatus between the posterior border of the symphysis pubis and the medial edge of the pubic visceral muscle) and ΔArea (the difference between the areas of the levator hiatus at rest and when performing the maximum Valsalva manoeuvre) were measured for the resting and maximum Valsalva manoeuvre states.