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Role of Puborectalis Muscle in the Genesis of Urethral Pressure.
MedLine Citation:
PMID:  22906663     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: The internal (smooth muscle) and the external (rhabdosphincter striated muscle) urethral sphincters have important roles in the genesis of urethral closure pressure. The U-shaped pelvic floor puborectalis muscle is important in the closure of anal and vaginal orifices in humans. We defined the contribution of the puborectalis to urethral pressure. MATERIALS AND METHODS: A total of 11 female rabbits were anesthetized and prepared to measure urethral, vaginal and anal canal pressure using manometric methods. Pressure was recorded at rest, after administration of pharmacological agents and during electrical stimulation of the puborectalis and rhabdosphincter sphincter muscles. Phenylephrine, sodium nitroprusside (Sigma-Aldrich®) and rocuronium bromide (PharMEDium, Lake Forest, Illinois) were used to define the relative contribution of smooth and striated muscles to urethral pressure. Histology of the pelvic floor hiatus was also studied. RESULTS: At rest mean ± SEM maximum urethral pressure was 13 ± 6 mm Hg. Sodium nitroprusside (50 μg/kg) infusion resulted in a 30% to 40% decrease in resting urethral pressure (mean 7.2 ± 0.2 mm Hg). Phenylephrine produced a dose dependent increase in urethral pressure (mean 17 ± 6, 25 ± 5 and 29 ± 6 for 5, 10 and 50 μg/kg intravenously, respectively). Electrical stimulation of the puborectalis muscle induced a stimulus dependent increase in urethral, vaginal and anal canal pressure. On the other hand, rhabdosphincter stimulation induced a stimulus intensity dependent increase in urethral pressure only. The increase in urethral pressure after puborectalis muscle stimulation was more than twofold higher than after rhabdosphincter stimulation. CONCLUSIONS: Our data prove that the puborectalis, a component of the pelvic floor muscles, is an important contributor to urethral pressure in the rabbit.
Authors:
M Raj Rajasekaran; Dongwan Sohn; Mitra Salehi; Valmik Bhargava; Helga Fritsch; Ravinder K Mittal
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-17
Journal Detail:
Title:  The Journal of urology     Volume:  -     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Gastroenterology, Department of Medicine, University of California-San Diego and Department of Medicine, San Diego Veterans Affairs Healthcare System, San Diego, California.
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