Dorschner W, Stolzenburg J U, Leutert G
Department of Urology, Leipzig University, FRG.
Urol Int. 1994;52(2):61-4. doi: 10.1159/000282574.
Micturition and urinary continence theories have been under discussion since the last century. Up to now all these theories have been unsatisfactory. There is an obvious discrepance between the anatomical presentation and the clinical perceptions and physiological phenomena. This was the reason for a renewed and global examination of the whole distal urinary tract. The results are published in five successive papers. Our own examinations are based on 30,000 serial sections of the bladder neck taken from 65 male and female cadavers of all age groups. The muscle system of the urinary bladder consists of a network of smooth muscle cells forming three layers. Caudally the longitudinal muscle layers form two special recently described structures: the collare vesicae and nodus vesicae. None of the muscle systems of the urinary bladder leaves the spatial dimension of the organ. Simply two anatomical structures fix the urinary bladder in the pelvis. Dorsally it is the musculus vesicoprostaticus and the musculus vesicovaginalis, respectively; ventrally the existence of the musculi pubovesicales is introduced. There is no involvement of the lamellas of the bladder muscles in the formation of the urinary sphincter. Therefore the morphological substrate for a hitherto generally acknowledge contribution of the detrusor vesicae to the active continence function does not exist.
自上世纪以来，排尿和尿失禁理论一直备受讨论。到目前为止，所有这些理论都不尽人意。解剖学表现与临床认知及生理现象之间存在明显差异。这就是对整个远端尿路进行重新全面检查的原因。结果发表在五篇连续的论文中。我们自己的检查基于从65具各年龄段男女尸体上获取的3万张膀胱颈连续切片。膀胱的肌肉系统由形成三层的平滑肌细胞网络组成。在尾部，纵向肌层形成两个最近才描述的特殊结构：膀胱领和膀胱结节。膀胱的任何肌肉系统都未超出器官的空间范围。仅有两个解剖结构将膀胱固定在骨盆中。在背侧分别是膀胱前列腺肌和膀胱阴道肌；在腹侧引入了耻骨膀胱肌的存在。膀胱肌肉薄片未参与尿道括约肌的形成。因此，不存在膀胱逼尿肌对主动控尿功能作出迄今普遍认可贡献的形态学基础。
