Abstract:
:The effects of pelvic floor muscle contraction on rectal and vesical function were studied in 19 healthy volunteers with the aim of shedding light on some of the hitherto vague aspects of the mechanisms involved in micturition and defecation and their disorders. Rectal and vesical pressures were recorded during puborectalis (PR) and levator ani (LA) muscle stimulation with the rectum or urinary bladder empty and full. Muscle stimulation was effected by needle EMG electrode. The pressure responses to stimulation of the PR and LA muscles were also recorded with these muscles and the rectum and urinary bladder individually anesthetized in 12 of the 19 subjects. The test was repeated using saline instead of xylocaine. PR and LA muscle stimulation produced no pressure response in the empty rectum or bladder. Upon rectal balloon distension with a mean of 156.6+/-34.2 ml of carbon dioxide the mean rectal pressure was 64.6+/-18.7 cm H2O, the subject felt the urge to evacuate and the balloon was expelled to the exterior. On PR muscle stimulation at rectal distension with the above volume, the subject did not feel the urge to evacuate, the rectal pressure was 8.2+/-1.6 cm H2O and the balloon was not expelled. Upon LA stimulation at the same volume, the urge persisted, the rectal pressure was higher and the balloon was expelled. Vesical filling with a mean of 378.2+/-23.6 ml of saline initiated the urge to urinate and elevated the vesical pressure. PR muscle stimulation at this volume aborted the urge and pressure elevation, while LA stimulation caused more elevation of the vesical pressure and spontaneous micturition. Bladder filling with a mean of 423.6+/-38.2 ml produced high vesical pressure and spontaneous urination, both of which were prevented by PR muscle stimulation but not by LA muscle stimulation. Stimulation of the PR and LA muscles during individual anesthetization of the rectum, bladder or PR and LA muscles resulted in no significant rectal or vesical pressure changes. Repetition of the test using saline instead of xylocaine resulted in rectal and vesical pressure responses similar to those without the use of saline. In conclusion, the decline in rectal and vesical responses upon PR muscle contraction indicates a reflex relationship which we term 'puborectalis rectovesical inhibitory reflex'. This reflex is suggested to abort the urge to defecate or urinate. In contrast, LA muscle contraction produced rectal and vesical pressure elevation which is suggested to be mediated through the 'levator rectovesical excitatory reflex'. 'This reflex is probably evoked to promote rectal and vesical evacuation.
journal_name
World J Uroljournal_title
World journal of urologyauthors
Shafik A,El-Sibai Odoi
10.1007/s003450100218keywords:
subject
Has Abstractpub_date
2001-08-01 00:00:00pages
278-84issue
4eissn
0724-4983issn
1433-8726journal_volume
19pub_type
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journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s003450050069
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journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-003-0340-5
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pub_type: 杂志文章
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journal_title:World journal of urology
pub_type: 杂志文章,多中心研究
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abstract::Local recurrent prostate cancer after radical treatment is found in the majority of men with a rising PSA. Salvage treatment procedures for recurrent disease, such as radiation therapy and ablative procedures, can provide long-term responses in well-selected cases. Prostate magnetic resonance imaging (MRI) allows diag...
journal_title:World journal of urology
pub_type: 杂志文章,评审
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pub_type: 杂志文章,meta分析
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-020-03463-x
更新日期:2020-09-30 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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更新日期:2004-06-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-020-03161-8
更新日期:2020-03-21 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s003450050142
更新日期:1999-10-01 00:00:00
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journal_title:World journal of urology
pub_type: 临床试验,杂志文章
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更新日期:2013-04-01 00:00:00
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journal_title:World journal of urology
pub_type: 已发布勘误
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更新日期:2020-10-24 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2020-11-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-019-02782-y
更新日期:2020-02-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章,meta分析
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更新日期:2019-12-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
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更新日期:1996-01-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
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journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/BF01836343
更新日期:1996-01-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-011-0655-6
更新日期:2011-04-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-011-0682-3
更新日期:2011-08-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-018-2242-6
更新日期:2018-07-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-019-03014-z
更新日期:2020-09-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章,多中心研究
doi:10.1007/s00345-014-1457-4
更新日期:2015-09-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00345-013-1228-7
更新日期:2014-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s00345-018-2405-5
更新日期:2019-03-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-013-1137-9
更新日期:2014-06-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-019-02647-4
更新日期:2019-10-01 00:00:00