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Functional striated sphincter component at the bladder neck: clinical implications

S V Yalla, F B Gabilondo, K J Blunt

    The Journal of Urology
    |September 1, 1977
    PubMed
    Summary
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    This study investigated the function of the striated urethral sphincter muscle near the bladder neck in men. Results show this muscle responds to stimuli, particularly in patients with upper motor neuron lesions, impacting bladder control.

    Area of Science:

    • Urology
    • Neuroscience
    • Physiology

    Background:

    • The striated urethral sphincter muscle plays a crucial role in urinary continence.
    • Understanding its functional anatomy, especially its proximal extension towards the bladder neck, is vital for diagnosing and managing lower urinary tract dysfunction.

    Purpose of the Study:

    • To functionally assess the proximal extension of the striated urethral sphincter muscle toward the bladder neck.
    • To evaluate urethral pressure responses to bulbocavernosus stimuli in normal males and patients with upper motor neuron lesions.

    Main Methods:

    • Synchronous cystosphincterometric studies were conducted.
    • Urethral pressure responses (contraction complexes) were measured at the vesicourethral junction, supramontane prostatic urethra, and membranous urethra.

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  • Repeated bulbocavernosus stimuli were applied.

    • Main Results:

    • All subjects exhibited positive responses at the membranous urethra.
    • Contraction complexes of lower amplitude were observed at the vesicourethral junction in 48% of subjects.
    • Responses at the supramontane prostatic urethra occurred in 71% of subjects.

    Conclusions:

    • The striated urethral sphincter muscle demonstrates functional activity extending towards the bladder neck.
    • These findings have implications for understanding detrusor-striated sphincter dyssynergia.
    • The study highlights the functional significance of the bladder neck's striated muscle component.