Role of positive urethrovesical feedback in vesical evacuation. The concept of a second micturition reflex: the urethrovesical reflex.

Abstract:

:Upon feeling the urge to urinate, the urinary bladder contracts, the urethral sphincters relax and urine flows through the urethra. These actions are mediated by the micturition reflex. We investigated the hypothesis that vesical contraction is maintained by positive feedback through continuous flow of urine through the urethra, and that the cessation of urine flow aborts detrusor contraction. Normal saline was infused into the urinary bladders of 17 healthy volunteers (age 35.2 years+/-4.2(SD); ten women and seven men) at a rate of 100 ml/min. On urge, which occurred at a mean volume of 408.6 ml+/-28.7 of saline, the subject micturated while the vesical and urethral pressures during voiding were being recorded; residual urine was measured. The test was repeated after anesthetizing the urethra with xylocaine gel or, on another occasion, after applying a bland gel. On micturition, the urine was evacuated as a continuous stream without straining; no residual fluid was collected. After urethral anesthetization, the fluid came out of the urethra in multiple intermittent spurts and only with excessive straining. There was a large amount of residual fluid (184.6 ml+/-28.4). The results of bland gel application showed no significant difference ( P>0.05) from those without gel. Detrusor contraction during micturition is suggested to be maintained by positive urethrovesical feedback elicited by the continued passage of urine through the urethra. This feedback seems to be effected through the urethrovesical reflex, which produces vesical contraction on stimulation of the urethral stretch receptors. Abortion of this reflex by urethral anesthetization resulted in failure of detrusor contraction and excessive straining was needed to achieve bladder evacuation in multiple spurts. The urethrovesical reflex is thus assumed to constitute a second micturition reflex responsible for the continuation of detrusor contraction and urination. The role of this reflex in the pathogenesis of micturition disorders needs to be studied.

journal_name

World J Urol

journal_title

World journal of urology

authors

Shafik A,Shafik AA,El-Sibai O,Ahmed I

doi

10.1007/s00345-003-0340-5

keywords:

subject

Has Abstract

pub_date

2003-08-01 00:00:00

pages

167-70

issue

3

eissn

0724-4983

issn

1433-8726

journal_volume

21

pub_type

杂志文章
  • Treatment of renal calcium stone disease with the synthetic glycosaminoglycan pentosan polysulphate.

    abstract::Glycosaminoglycans (GAGs) are potent inhibitors of calcium oxalate growth and aggregation. The synthetic GAG pentosan polysulphate (PPS) was used in the treatment of patients with renal calcium stone disease. Altogether, 121 patients were included in an open trial over a 3-year-period. The average stone episode rate a...

    journal_title:World journal of urology

    pub_type: 临床试验,杂志文章

    doi:10.1007/BF00182052

    authors: Fellström B,Backman U,Danielson B,Wikström B

    更新日期:1994-01-01 00:00:00

  • Stress incontinence surgery at the time of prolapse surgery: mandatory or forbidden?

    abstract:INTRODUCTION:Concomitant anti-incontinence surgery at the time of prolapse repair has been a long-debated topic. Still today, there remains no clear answer to this question, although in recent years the literature has become more robust with the addition of more randomized controlled trials. The lifetime risk for women...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审

    doi:10.1007/s00345-015-1591-7

    authors: King AB,Goldman HB

    更新日期:2015-09-01 00:00:00

  • The rationale and the role of lymph node dissection in renal cell carcinoma.

    abstract:PURPOSE:Although the role of lymph node dissection (LND) is well defined in many urological settings, uncertainty regarding need for LND still exists for patients with renal cell carcinoma (RCC). The aim of the current review is to highlight the rationale for performing or omitting LND at the time of renal surgery. ME...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审

    doi:10.1007/s00345-016-1886-3

    authors: Capitanio U,Leibovich BC

    更新日期:2017-04-01 00:00:00

  • Multivariate risk prediction tools including MRI for individualized biopsy decision in prostate cancer diagnosis: current status and future directions.

    abstract:BACKGROUND AND PURPOSE:Individualized risk-adapted algorithms in prostate cancer (PCa) diagnosis using predictive prebiopsy variables in addition to prostate-specific antigen value may result in a considerable reduction of unnecessary systematic biopsies. Multi-parametric magnetic resonance imaging (mpMRI) has emerged ...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审

    doi:10.1007/s00345-019-02707-9

    authors: Schoots IG,Roobol MJ

    更新日期:2020-03-01 00:00:00

  • Early recovery after surgery for radical cystectomy: comprehensive assessment and meta-analysis of existing protocols.

    abstract:PURPOSE:Different enhanced recovery after surgery (ERAS) protocols (EP) for radical cystectomy (RC) have been published. Protocols highly differ in number of included items and specific measures. MATERIALS AND METHODS:A systematic review and meta-analysis on EPs in RC were performed using the databases MedLine, Cochra...

    journal_title:World journal of urology

    pub_type: 杂志文章

    doi:10.1007/s00345-020-03133-y

    authors: Wessels F,Lenhart M,Kowalewski KF,Braun V,Terboven T,Roghmann F,Michel MS,Honeck P,Kriegmair MC

    更新日期:2020-12-01 00:00:00

  • OnabotulinumtoxinA intradetrusorial injections improve sexual function in female patients affected by multiple sclerosis: preliminary results.

    abstract:PURPOSE:To investigate the effects of onabotulinum toxin type A (Onabot/A) intravesical injections on urinary and sexual function in a group of patients affected by multiple sclerosis (MS). METHODS:We enrolled 31 MS female patients with symptoms of overactive bladder and detrusor overactivity. All patients underwent u...

    journal_title:World journal of urology

    pub_type: 临床试验,杂志文章

    doi:10.1007/s00345-015-1578-4

    authors: Giannantoni A,Proietti S,Giusti G,Gubbiotti M,Millefiorini E,Costantini E,Berardelli A,Conte A

    更新日期:2015-12-01 00:00:00

  • Role of cathepsin D in prostatic cancer cell growth and its regulation by brefeldin A.

    abstract::We investigated a possible relationship between brefeldin A (BFA), an antibiotic, and cathepsin D (Cat.D), a lysosomal protease, in prostate cancer proliferation. Effects of BFA (30 ng/ml) were examined on the growth of three human prostatic cancer cell lines, PC-3, DU-145, and LNCaP cells. Its effect on Cat.D in thes...

    journal_title:World journal of urology

    pub_type: 杂志文章

    doi:10.1007/pl00007099

    authors: Konno S,Cherry JP,Mordente JA,Chapman JR,Choudhury MS,Mallouh C,Tazaki H

    更新日期:2001-08-01 00:00:00

  • Comparison of adjustable male slings and artificial urinary sphincter in the treatment of male urinary incontinence: a retrospective analysis of patient selection and postoperative continence status.

    abstract:PURPOSE:To analyze and compare preoperative patient characteristics and postoperative results in men with stress urinary incontinence (SUI) selected for an adjustable male sling system or an artificial urinary sphincter (AUS) in a large, contemporary, multi-institutional patient cohort. METHODS:658 male patients who u...

    journal_title:World journal of urology

    pub_type: 杂志文章

    doi:10.1007/s00345-018-2523-0

    authors: Grabbert M,Hüsch T,Kretschmer A,Kirschner-Hermanns R,Anding R,Rose A,Friedl A,Obaje A,Heidenreich A,Brehmer B,Naumann CM,Queissert F,Loertzer H,Pfitzenmaier J,Nyarangi-Dix J,Kurosch M,Olianas R,Homberg R,Abdunnur R,

    更新日期:2019-07-01 00:00:00

  • The prognostic role of preoperative circulating neutrophil-lymphocyte ratio in primary bladder cancer patients undergoing radical cystectomy: a meta-analysis.

    abstract:BACKGROUND:Systemic inflammatory response (SIR) plays important roles in initiation, promotion and progression of tumor. However, the prognostic role of preoperative circulating neutrophil-lymphocyte ratio (NLR) (known as a marker of SIR) in human primary bladder cancer (BC) undergoing radical cystectomy (RC) remains c...

    journal_title:World journal of urology

    pub_type: 杂志文章,meta分析

    doi:10.1007/s00345-018-2593-z

    authors: Hu G,Xu F,Zhong K,Wang S,Xu Q,Huang L,Cheng P

    更新日期:2019-09-01 00:00:00

  • Familial risk of urological cancers: data for clinical counseling.

    abstract::Familial risks for cancer are important for clinical counseling and understanding cancer etiology. The nationwide Swedish Family-Cancer Database includes all Swedes born in 1932 and later (0 to 68-year-old offspring) with their parents, totaling over 10.2 million individuals. Urological cancer cases were retrieved fro...

    journal_title:World journal of urology

    pub_type: 杂志文章

    doi:10.1007/s00345-003-0375-7

    authors: Hemminki K,Li X,Czene K

    更新日期:2004-02-01 00:00:00

  • Long-term urinary adverse effects of pelvic radiotherapy.

    abstract:OBJECTIVE:Radiation for tumors arising in the pelvis has been utilized for over a 100 years. Adverse effects (AEs) of radiotherapy (RT) continue to accumulate with time and are reported to show decades after treatment. The benefit of RT for pelvic tumors is well described as is their acute AEs. Late AEs are less well d...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审

    doi:10.1007/s00345-010-0603-x

    authors: Elliott SP,Malaeb BS

    更新日期:2011-02-01 00:00:00

  • Prostate-specific antigen kinetics after I125-brachytherapy for prostate adenocarcinoma.

    abstract:PURPOSE:To investigate a potential correlation between the achievement of a cut-off of nadir PSA (nPSA) after brachytherapy (BRT) with biochemical Disease-Free Survival (bDFS) and to define the rate of post-BRT PSA bounces. METHODS:Retrospective analysis was carried out in 105 consecutive patients affected with early-...

    journal_title:World journal of urology

    pub_type: 杂志文章

    doi:10.1007/s00345-012-0932-z

    authors: Guarneri A,Botticella A,Ragona R,Filippi AR,Munoz F,Casetta G,Gontero P,Tizzani A,Ricardi U

    更新日期:2013-04-01 00:00:00

  • Comparison of cell cycle progression score with two immunohistochemical markers (PTEN and Ki-67) for predicting outcome in prostate cancer after radical prostatectomy.

    abstract:PURPOSE:Previous studies of the cell cycle progression (CCP) score in surgical specimens of prostate cancer (PCa) in patients treated by radical prostatectomy (RP) demonstrated significant association with time to biochemical recurrence (BCR). In this study, we compared the ability of the CCP score and the expression o...

    journal_title:World journal of urology

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s00345-018-2290-y

    authors: Léon P,Cancel-Tassin G,Drouin S,Audouin M,Varinot J,Comperat E,Cathelineau X,Rozet F,Vaessens C,Stone S,Reid J,Sangale Z,Korman P,Rouprêt M,Fromond-Hankard G,Cussenot O

    更新日期:2018-09-01 00:00:00

  • Effects of magnesium citrate and phytin on reducing urinary calcium excretion in rats.

    abstract::The aim of this study was to determine and compare the effects of both magnesium citrate and phytin on reducing urinary calcium excretion under high-calcium-diet conditions during single and combined treatments. An animal experiment was carried out over a period of 4 weeks in 35 male rats. Urinary calcium excretion wa...

    journal_title:World journal of urology

    pub_type: 杂志文章

    doi:10.1007/BF00184113

    authors: Wu N,Thon WF,Krah H,Schlick R,Jonas U

    更新日期:1994-01-01 00:00:00

  • XPA-210: a new proliferation marker to characterize tumor biology and progression of renal cell carcinoma.

    abstract:PURPOSE:Recent lung cancer data have shown an association of XPA-210, a key peptide of thymidine kinase, with advanced disease. We thus assessed its proliferation status in primary (M0) and metastatic (M1) renal cell carcinoma (RCC). METHODS:Paraffin slides from 30 patients (mean age: 61.2 years; range: 42-84) with cl...

    journal_title:World journal of urology

    pub_type: 杂志文章

    doi:10.1007/s00345-010-0621-8

    authors: Gakis G,Hennenlotter J,Scharpf M,Hevler J,Schilling D,Kuehs U,Stenzl A,Schwentner C

    更新日期:2011-12-01 00:00:00

  • Glanuloplasty by ventral skin interposition in hypospadias repair: preliminary report.

    abstract:PURPOSE:It was our aim in this study to develop a technique that is rather simple, overcomes the problems of Devine and Horton glanuloplasty in patients with small glans, and is flexible to be tailored to any hypospadias surgery. METHODS:A total of 11 patients were included in this preliminary report. A triangular ski...

    journal_title:World journal of urology

    pub_type: 杂志文章

    doi:10.1007/s00345-009-0386-0

    authors: Shaker H,Ezzat M

    更新日期:2009-10-01 00:00:00

  • High hospital and surgeon volume and its impact on overall survival after radical cystectomy among patients with bladder cancer in Quebec.

    abstract:INTRODUCTION AND OBJECTIVES:Previous studies reported improved outcomes for bladder cancer patients who had radical cystectomy (RC) performed by surgeons and hospitals with high annual RC volumes. The objective of this study was to determine the effect of high hospital and surgeon volume on overall survival after RC fo...

    journal_title:World journal of urology

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s00345-014-1457-4

    authors: Santos F,Zakaria AS,Kassouf W,Tanguay S,Aprikian A

    更新日期:2015-09-01 00:00:00

  • Initial experiences with the Hemopatch® as a hemostatic agent in zero-ischemia partial nephrectomy.

    abstract:PURPOSE:Nephron-sparing surgery (NSS) is the gold standard treatment for resectable renal tumors. In the last decade, laparoscopic partial nephrectomy (LPN) has evolved in technical, surgical and oncological aspects and is an accepted treatment option for local-stage renal tumors. Improvements in not only surgical tech...

    journal_title:World journal of urology

    pub_type: 杂志文章

    doi:10.1007/s00345-014-1404-4

    authors: Imkamp F,Tolkach Y,Wolters M,Jutzi S,Kramer M,Herrmann T

    更新日期:2015-10-01 00:00:00

  • Systemic therapy in metastatic renal cell carcinoma.

    abstract:PURPOSE:Current systemic treatment of targeted therapies, namely the vascular endothelial growth factor-antibody (VEGF-AB), VEGF receptor tyrosine kinase inhibitor (TKI) and mammalian target of rapamycin (mTOR) inhibitors, have improved progression-free survival and replaced non-specific immunotherapy with cytokines in...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审

    doi:10.1007/s00345-016-1868-5

    authors: Bedke J,Gauler T,Grünwald V,Hegele A,Herrmann E,Hinz S,Janssen J,Schmitz S,Schostak M,Tesch H,Zastrow S,Miller K

    更新日期:2017-02-01 00:00:00

  • Five compelling UTI questions after kidney transplant.

    abstract:PURPOSE:Urinary tract infection (UTI) is the most common bacterial infection among infectious complications in kidney transplant recipients (KTR). After transplantation, infections can result from surgical complications, donor-derived infections, pre-existing recipient infections, and nosocomial infections. Post-transp...

    journal_title:World journal of urology

    pub_type: 杂志文章

    doi:10.1007/s00345-020-03173-4

    authors: Aydın S,Patil A,Desai M,Simforoosh N

    更新日期:2020-11-01 00:00:00

  • Establishing and monitoring of urethral sphincter deficiency in a large animal model.

    abstract:BACKGROUND:Different methods for induction and monitoring of urethral sphincter deficiency were explored in a large animal model. METHODS:Sphincter deficiency was established in female pigs by dilatation and cauterization, and amount and frequencies of voiding were monitored and explored by pad test. Sphincteric closu...

    journal_title:World journal of urology

    pub_type: 杂志文章

    doi:10.1007/s00345-017-2088-3

    authors: Kelp A,Albrecht A,Amend B,Klünder M,Rapp P,Sawodny O,Stenzl A,Aicher WK

    更新日期:2017-12-01 00:00:00

  • Endoscopic surgical simulation using low-fidelity and virtual reality transurethral resection simulators in urology simulation boot camp course: trainees feedback assessment study.

    abstract:OBJECTIVES:The objective of our study was to study trainees' feedback and rating of models for training transurethral resection of bladder lesions (TURBT) and prostate (TURP) during simulation. METHODS:The study was performed during the ''Transurethral resection (TUR) module" at the boot camp held in 2019. Prior to th...

    journal_title:World journal of urology

    pub_type: 杂志文章

    doi:10.1007/s00345-020-03559-4

    authors: Berridge C,Kailavasan M,Athanasiadis G,Gkentzis A,Tassadaq T,Palit V,Rai B,Biyani CS,Nabi G

    更新日期:2021-01-04 00:00:00

  • Laparoscopic management of renal cystic disease.

    abstract::Renal cystic disease, ranging from simple cysts to autosomal dominant polycystic kidney disease (ADPKD), can lead to significant complications such as pain, hypertension, infection, upper urinary tract obstruction, and even renal failure. For patients with preserved renal function, laparoscopic ablation of renal cysts...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审

    doi:10.1007/pl00007076

    authors: Dunn MD,Clayman RV

    更新日期:2000-09-01 00:00:00

  • Understanding patients' preferences for surgical management of urethral stricture disease.

    abstract:OBJECTIVES:To understand how prioritization of treatment attributes and treatment choice varies by patient characteristics, we sought to specifically determine how demographic variables affect patient treatment preference. PATIENTS AND METHODS:Male patients with urethral stricture disease participated in a choice-base...

    journal_title:World journal of urology

    pub_type: 杂志文章

    doi:10.1007/s00345-017-2066-9

    authors: Hampson LA,Lin TK,Wilson L,Allen IE,Gaither TW,Breyer BN

    更新日期:2017-11-01 00:00:00

  • Sky is no limit for ureteroscopy: extending the indications and special circumstances.

    abstract:PURPOSE:To critically review and synthesize data of ureteroscopy (URS) in different circumstances that all urologists may encounter during everyday clinical practice, such as pregnancy, obesity, bleeding diathesis, renal stones larger than 2 cm, calyceal diverticula, and kidney malformations. METHODS:According to PRIS...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审

    doi:10.1007/s00345-014-1345-y

    authors: Giusti G,Proietti S,Peschechera R,Taverna G,Sortino G,Cindolo L,Graziotti P

    更新日期:2015-02-01 00:00:00

  • Identification of molecular targets in urologic oncology.

    abstract:OBJECTIVES:Molecular targets in cancer diagnosis and therapy have come to the fore of the oncology field in the last decade. Their identification is rooted in basic science investigation and enhanced knowledge in the fields of genetics, biochemistry, molecular and tumor biology, and pathology among others. METHODS:A m...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审

    doi:10.1007/s00345-008-0339-z

    authors: Evans CP

    更新日期:2009-02-01 00:00:00

  • Elevated plasma aldosterone is an independent risk factor for erectile dysfunction in men.

    abstract:INTRODUCTION:Erectile dysfunction (ED) and cardiovascular disease (CVD) share a great number of common risk factors. There is growing evidence that aldosterone, an independent CVD risk factor, is associated with ED. AIMS:The purpose of this study was to determine the relationship between plasma aldosterone and erectil...

    journal_title:World journal of urology

    pub_type: 杂志文章

    doi:10.1007/s00345-015-1723-0

    authors: Wu F,Mao S,Yu T,Jiang H,Ding Q,Xu G

    更新日期:2016-07-01 00:00:00

  • Change in storage symptoms following laser prostatectomy: comparison between photoselective vaporization of the prostate (PVP) and holmium laser enucleation of the prostate (HoLEP).

    abstract:PURPOSE:To compare serial changes of postoperative storage symptoms between PVP and HoLEP, and to identify the predictors influencing postoperative improvement of storage symptoms. METHODS:A total of 486 men (PVP group: 213 cases; HoLEP group: 273 cases), in whom 12-month follow-up data were available, were included i...

    journal_title:World journal of urology

    pub_type: 杂志文章

    doi:10.1007/s00345-014-1424-0

    authors: Cho MC,Ha SB,Oh SJ,Kim SW,Paick JS

    更新日期:2015-08-01 00:00:00

  • Optimal treatment of locally advanced prostate cancer.

    abstract::The treatment of clinically locally advanced prostate cancer (cT3-4) is subject to controversies. Patients with lymph node metastases as well as patients with overstaged localized and thus curable disease fall into this category. Radical prostatectomy, external beam radiotherapy and early or deferred hormonal therapy ...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审

    doi:10.1007/s00345-007-0158-7

    authors: Wirth MP,Hakenberg OW,Froehner M

    更新日期:2007-04-01 00:00:00

  • CATCH-22: a manual bladder washout protocol to improve care for clot retention.

    abstract:PURPOSE:To review current practices in manual bladder washouts (MBW) for haematuria with clot retention, comparing those conducted by a urology unit to other inpatient services. Secondly, to describe a standardised protocol for MBWs. METHODS:Prospective data were collected for patients treated for clot retention, from...

    journal_title:World journal of urology

    pub_type: 杂志文章

    doi:10.1007/s00345-018-2346-z

    authors: Clarebrough E,McGrath S,Christidis D,Lawrentschuk N

    更新日期:2018-12-01 00:00:00