Shafik Ahmed, Shafik Ismail A, El Sibai Olfat, Shafik Ali A
Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt.
BMC Urol. 2008 Mar 2;8:4. doi: 10.1186/1471-2490-8-4.
The reaction of the corpora cavernosa (CC), the corpus spongiosum (CS), the bulbocavernosus (BCM) and ischiocavernosus (ICM) muscles to passage of urine through the urethra during micturition is not known. We investigated the hypothesis that the passage of urine through the urethra stimulates the corporal tissue and cavernosus muscles.
In 30 healthy men (mean age 42.8 +/- 11.7 years), the electromyographic activity (EMG) of the CC, CS, BCM, and ICM were recorded before and during micturition, and on interruption of and straining during micturition. These tests were repeated after individual anesthetization of urethra, corporal tissue, and cavernosus muscles.
During micturition, the slow wave variables (frequency, amplitude, conduction velocity) of the CC and CS decreased while the motor unit action potentials of the BCM and ICM increased; these EMG changes were mild and returned to the basal values on interruption or termination of micturition. Micturition after individual anesthetization of urethra, corporal tissue and cavernosal muscles did not effect significant EMG changes in these structures, while saline administration produced changes similar to those occurring before saline administration.
The decrease of sinusoidal and increase of cavernosus muscles' EMG activity during micturition apparently denotes sinusoidal relaxation and cavernosus muscles contraction. Sinusoidal muscle relaxation and cavernosus muscles contraction upon micturition are suggested to be mediated through a 'urethro-corporocavernosal reflex'. These sinusoidal and cavernosus muscle changes appear to produce a mild degree of penile tumescence and stretch which might assist in urinary flow during micturition.
目前尚不清楚在排尿过程中,海绵体、尿道海绵体、球海绵体肌和坐骨海绵体肌对尿液通过尿道的反应。我们研究了尿液通过尿道会刺激海绵体组织和海绵体肌这一假设。
对30名健康男性(平均年龄42.8±11.7岁),在排尿前、排尿期间、排尿中断及用力排尿时记录海绵体、尿道海绵体、球海绵体肌和坐骨海绵体肌的肌电图活动。在分别麻醉尿道、海绵体组织和海绵体肌后重复这些测试。
排尿期间,海绵体和尿道海绵体的慢波变量(频率、振幅、传导速度)降低,而球海绵体肌和坐骨海绵体肌的运动单位动作电位增加;这些肌电图变化轻微,在排尿中断或结束时恢复到基础值。分别麻醉尿道、海绵体组织和海绵体肌后排尿,这些结构的肌电图没有明显变化,而注射生理盐水产生的变化与注射前相似。
排尿期间海绵体窦波减少和海绵体肌肌电图活动增加显然表明海绵体窦松弛和海绵体肌收缩。排尿时海绵体窦肌松弛和海绵体肌收缩可能是通过“尿道-海绵体反射”介导的。这些海绵体窦和海绵体肌的变化似乎会产生轻度阴茎肿胀和伸展,这可能有助于排尿时的尿流。