Weledji Elroy P, Eyongeta Divine, Ngounou Eleanor
Departments of Anatomy and Surgery, Faculty of Health Sciences, University of Buea, Gastrointestinal Surgeon, Regional Hospital Limbe, Limbe, Cameroon.
Departments of Anatomy and Surgery, Faculty of Health Sciences, University of Buea, Urologist, Regional Hospital, Limbe, Cameroon.
Clin Anat. 2019 Jan;32(1):60-67. doi: 10.1002/ca.23296. Epub 2018 Nov 26.
Normal voiding needs a coordinated, sustained bladder contraction of adequate size and duration. It requires a decrease in resistance of the bladder neck and urethra and no obstruction. Voiding problems can arise from abnormal storage of urine or problems with urinary control. The aim of this article was to review the functional anatomy and physiology of urinary control and micturition and the pathophysiology of urinary control problems. The Medline (PubMed) database, Cochrane Library, and Science Citation Index were searched electronically to identify original published studies on bladder anatomy, function and urinary control. References were searched from relevant chapters in specialized texts and all were included. Voiding problems are the most common presenting urological symptoms in general medical practice. Urinary incontinence occurs when the normal process of storing and passing urine is disrupted. A history of coexisting fecal incontinence suggests a neuropathic etiology. A better understanding of the physiology of urinary control could lead to preventive measures for postoperative urinary retention and incontinence such as fluid restriction and to appropriate anesthesia/analgesia, autonomic nerve preservation, total mesorectal excision (TME) for rectal cancer, and biofeedback exercises. It could also suggest appropriate therapeutic measures for established urinary incontinence. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc.
正常排尿需要膀胱进行协调、持续且大小和持续时间合适的收缩。这需要膀胱颈和尿道的阻力降低且无梗阻。排尿问题可能源于尿液储存异常或排尿控制问题。本文的目的是综述排尿控制和排尿的功能解剖学与生理学以及排尿控制问题的病理生理学。通过电子检索Medline（PubMed）数据库、Cochrane图书馆和科学引文索引，以识别已发表的关于膀胱解剖、功能和排尿控制的原始研究。从专业文献的相关章节中检索参考文献并全部纳入。排尿问题是普通医疗实践中最常见的泌尿外科症状。当储存和排尿的正常过程受到干扰时，就会发生尿失禁。同时存在大便失禁的病史提示神经源性病因。更好地理解排尿控制的生理学可能会带来预防术后尿潴留和尿失禁的措施，如限制液体摄入以及采取适当的麻醉/镇痛、保留自主神经、直肠癌的全直肠系膜切除术（TME）和生物反馈训练。这也可能为已确诊的尿失禁提示适当的治疗措施。《临床解剖学》，2018年。©2018威利期刊公司。
