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Announcing the SUFU Visiting Professorship
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Diokno-Lapides Essay Contest
Announcing the Diokno-Lapides Essay Contest is NOW OPEN to all physicians, PhD scientists, and MD and PhD trainees throughout the world! ...
SUNA Core Curriculum for Urologic Nursing
The first edition of the SUNA Core Curriculum for Urologic Nursing is now available. This comprehensive publication is an excellent resource for all urologic nurses....
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FDA Reclassification of Surgical Instrumentation
As anticipated, the FDA reclassified the surgical instrumentation for use with urogynecological surgical mesh from class I (general controls) to class II (special controls) effective January 6, 2017. ...
Neurourology and Urodynamics
Peptidergic nerve fibers in the urethra: Morphological and neurochemical characteristics in female mice of reproductive age
Friday, October 20, 2017
Background Peptidergic nerve fibers provide important contributions to urethral function. Urethral innervation of female mice is not well documented. Aims To determine the distribution and projection sites of nerve fibers immunoreactive for vasoactive intestinal peptide (VIP), calcitonin gene‐related peptide (CGRP), substance P (SP), and neuropeptide Y (NPY) in the urethra of wild‐type control mice and compare innervation characteristics between the proximal and distal urethra of young nullipara and older multipara mice. Furthermore, to identify the location and neurochemical coding of the spinal afferent nerve endings in the urethra, whose sensory neurons reside in lumbosacral dorsal root ganglia (DRG). Methods Multiple labeling immunohistochemistry of urethral sections of nulliparous (6‐8 weeks old), and multiparous (9‐12 months old) mice, and anterograde axonal tracing from L5‐S2 (DRG) in vivo. Results Abundant VIP‐, CGRP‐, SP‐, and NPY‐immunoreactive nerve fibers were identified in the adventitia, muscularis, and lamina propria of proximal and distal segments of the urethra. A proportion of fibers were closely associated with blood vessels, glands, and cells immunoreactive for PGP9.5. The epithelium contained abundant nerve fibers immunoreactive for CGRP and/or SP. Epithelial innervation was increased in the distal urethra of multipara mice. Abundant fibers were traced from L5‐S2 DRG to all urethral regions. Conclusions We present the first identification of spinal afferent endings in the urethra. Peptidergic nerve fibers, including multiple populations of spinal afferents, provide rich innervation of the female mouse urethra. The morphology of fibers in the epithelium and other regions suggests multiple nerve‐cell interactions impacting on urethral function.
A historical perspective and evolution of the treatment of male urinary incontinence
Friday, October 20, 2017
Aims To describe the historical changes from antiquity until present in the presentation and treatment of male urinary incontinence. Methods A literature review of PubMed articles in English pertaining to male incontinence was performed. Results Male urinary incontinence was first mentioned in Egyptian manuscripts in 1500 B.C. In 1564, Ambroise Pare designed portable urinals for incontinent males. Wilhem Hildanus created the first condom catheter with pig bladder in the 1600s and was also credited with fashioning the first penile clamp. Lorenz Heister introduced a perineal bulbar urethral compression belt in 1747 which would provide the blueprint for air‐inflated bulbar urethral compression devices such as the one designed by S.A. Vincent in 1960. Robert Gersuny performed the first periurethral paraffin injection bulking therapy in the late 19th century. In 1929, Frederic Foley introduced the modern catheter, and also credited with conception of the first artificial sphincter. From 1970 to 1973, Joseph Kaufman surgically created bulbar compression for post‐prostatectomy incontinence, but not before designing the first male sling with John Berry in 1958. In 1973, F. Brantley Scott introduced the first multi‐component artificial inflatable sphincter. Improvements upon periurethral bulking therapy occurred rapidly in the late 20th century with Teflon, collagen, autologous adipose, tissue and cross‐linked silicone gels. Since 2007, stem cell injection therapy has emerged as a new therapeutic option for incontinence; however, results are mixed and remains experimental. Conclusion Treatment for male urinary incontinence has evolved from noninvasive devices to various surgical procedures. Artificial sphincters remain the gold‐standard therapy for male urinary incontinence.
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