-
Physiological Reviews Jul 2004The detrusor smooth muscle is the main muscle component of the urinary bladder wall. Its ability to contract over a large length interval and to relax determines the... (Review)
Review
The detrusor smooth muscle is the main muscle component of the urinary bladder wall. Its ability to contract over a large length interval and to relax determines the bladder function during filling and micturition. These processes are regulated by several external nervous and hormonal control systems, and the detrusor contains multiple receptors and signaling pathways. Functional changes of the detrusor can be found in several clinically important conditions, e.g., lower urinary tract symptoms (LUTS) and bladder outlet obstruction. The aim of this review is to summarize and synthesize basic information and recent advances in the understanding of the properties of the detrusor smooth muscle, its contractile system, cellular signaling, membrane properties, and cellular receptors. Alterations in these systems in pathological conditions of the bladder wall are described, and some areas for future research are suggested.
Topics: Animals; Hormones; Humans; Muscle Contraction; Muscle Relaxation; Muscle, Smooth; Nervous System; Nervous System Physiological Phenomena; Urinary Bladder; Urinary Bladder Diseases; Urinary Bladder Neck Obstruction; Urologic Diseases
PubMed: 15269341
DOI: 10.1152/physrev.00038.2003 -
Journal of Nanobiotechnology Nov 2021Bladder cancer (BC) is a common malignancy in the genitourinary system and the current theranostic approaches are unsatisfactory. Sensitivity and specificity of current... (Review)
Review
Bladder cancer (BC) is a common malignancy in the genitourinary system and the current theranostic approaches are unsatisfactory. Sensitivity and specificity of current diagnosis methods are not ideal and high recurrence and progression rates after initial treatment indicate the urgent need for management improvements in clinic. Nanotechnology has been proposed as an effective method to improve theranosis efficiency for both non-muscle invasive bladder cancer (NMIBC) and muscle invasive bladder cancer (MIBC). For example, gold nanoparticles (AuNPs) have been developed for simple, fast and sensitive urinary sample test for bladder cancer diagnosis. Nanoparticles targeting bladder cancers can facilitate to distinguish the normal and abnormal bladder tissues during cystoscopy and thus help with the complete removal of malignant lesions. Both intravenous and intravesical agents can be modified by nanotechnology for targeted delivery, high anti-tumor efficiency and excellent tolerability, exhibiting encouraging potential in bladder cancer treatment. Photosensitizers and biological agents can also be delivered by nanotechnology, intermediating phototherapy and targeted therapy. The management of bladder cancer remained almost unchanged for decades with unsatisfactory effect. However, it is likely to change with the fast-developed nanotechnology. Herein we summarized the current utility of nanotechnology in bladder cancer diagnosis and treatment, providing insights for the future designing and discovering novel nanoparticles for bladder cancer management.
Topics: Animals; Humans; Mice; Nanoparticles; Theranostic Nanomedicine; Urinary Bladder; Urinary Bladder Neoplasms
PubMed: 34838048
DOI: 10.1186/s12951-021-01104-y -
Nature Dec 2020Henry Miller stated that "to relieve a full bladder is one of the great human joys". Urination is critically important in health and ailments of the lower urinary tract...
Henry Miller stated that "to relieve a full bladder is one of the great human joys". Urination is critically important in health and ailments of the lower urinary tract cause high pathological burden. Although there have been advances in understanding the central circuitry in the brain that facilitates urination, there is a lack of in-depth mechanistic insight into the process. In addition to central control, micturition reflexes that govern urination are all initiated by peripheral mechanical stimuli such as bladder stretch and urethral flow. The mechanotransduction molecules and cell types that function as the primary stretch and pressure detectors in the urinary tract mostly remain unknown. Here we identify expression of the mechanosensitive ion channel PIEZO2 in lower urinary tract tissues, where it is required for low-threshold bladder-stretch sensing and urethral micturition reflexes. We show that PIEZO2 acts as a sensor in both the bladder urothelium and innervating sensory neurons. Humans and mice lacking functional PIEZO2 have impaired bladder control, and humans lacking functional PIEZO2 report deficient bladder-filling sensation. This study identifies PIEZO2 as a key mechanosensor in urinary function. These findings set the foundation for future work to identify the interactions between urothelial cells and sensory neurons that control urination.
Topics: Animals; Female; Humans; Ion Channels; Mechanotransduction, Cellular; Mice; Pressure; Reflex; Sensory Receptor Cells; Urinary Bladder; Urinary Tract; Urination; Urothelium
PubMed: 33057202
DOI: 10.1038/s41586-020-2830-7 -
Annals of the Royal College of Surgeons... Nov 2022We report a rare complication involving a healthy 45-year-old male patient who underwent an emergency laparoscopic appendicectomy for acute perforated gangrenous...
We report a rare complication involving a healthy 45-year-old male patient who underwent an emergency laparoscopic appendicectomy for acute perforated gangrenous appendicitis. The patient was catheterised pre- procedure and the ports were inserted under vision. Upon completion of the procedure, a 15 Fr Robinson drain was left in the pelvis and was fed through the suprapubic port hole. Postoperatively the patient developed worsening, generalised abdominal pain and high output from the drain. The patient was re-catheterised but the computed tomography (CT) cystogram did not show any injury to the bladder. The drain fluid creatinine was noted to be raised (>4,000), indicating that urine was leaking into the drain. Conventional cystogram confirmed a contrast leak from the dome around the drain. Flexible cystoscopy confirmed that the drain had transversed the vesicourachal diverticula. The drain was pulled back and converted to a suprapubic catheter with the patient subsequently being discharged. Vesicourachal diverticula is a rare and often asymptomatic anomaly. When undertaking laparoscopic surgery, precautions should be taken to prevent port site injury such as catheterising the patient to ensure the bladder is empty and inserting the ports under direct vision. It is safer to visualise muscle rather than peritoneum during port insertion. In this case, the bladder diverticula was noticed extraperitoneally. Though the indirect CT cystogram reported no injury, this was unreliable as the bladder was not distended which led to the subtle injury being missed. Traditional cystogram should be considered in cases with a negative CT cystogram and a strong suspicion of bladder injury.
Topics: Male; Humans; Middle Aged; Urinary Bladder; Diverticulum; Urinary Bladder Diseases; Cystoscopy
PubMed: 35446699
DOI: 10.1308/rcsann.2021.0344 -
Urology Journal Sep 2015Recently, occurrence of urinary tract endometriosis (UTE) is more frequently diagnosed. According to literature, it refers to approximately 0.3 to even 12% of all women... (Review)
Review
Recently, occurrence of urinary tract endometriosis (UTE) is more frequently diagnosed. According to literature, it refers to approximately 0.3 to even 12% of all women with endometriosis. The pathogenesis of UTE has not been clearly explained so far. The actually proposed hypotheses include embryonic, migration, transplantation, and iatrogenic theory. Most frequently UTE affects bladder, less often ureters and kidneys. One-third of patients remains asymptomatic or exhibits only minor manifestations. In symptomatic patients main complaints include dysuria, urinary urgency, and/or frequency, painful micturition, and burning sensation in the urethra and discomfort in the retropubic area. Treatment of UTE is challenging and can be pharmacological, surgical or can be a combination of both methods. In this paper we present a review of the literature concerning the UTE, its diagnosis and treatment.
Topics: Diagnosis, Differential; Endometriosis; Female; Humans; Urinary Bladder; Urinary Bladder Diseases; Urination; Urination Disorders
PubMed: 26341760
DOI: No ID Found -
Autonomic Neuroscience : Basic &... May 2014A hallmark of functional pain syndromes, such as bladder pain syndrome/interstitial cystitis (BPS/IC) is pain in the absence of demonstrable infection or pathology of... (Review)
Review
A hallmark of functional pain syndromes, such as bladder pain syndrome/interstitial cystitis (BPS/IC) is pain in the absence of demonstrable infection or pathology of the viscera or associated nerves. There are no clear definitions of this syndrome, no proven etiologies and no effective treatments able to eradicate the symptoms. This condition is characterized by suprapubic pain, associated with bladder filling and can also be accompanied by a persistent strong desire to void, increased frequency of urination and nocturia. Severe cases of this disorder, which affects primarily women, can have considerable impact on the quality of life of patients due to extreme pain and urinary frequency, which are often difficult to treat. In addition, BPS/IC patients may also suffer co-morbid conditions where pain is a common symptom (such as irritable bowel syndrome, fibromyalgia). Theories explaining the pathology of bladder pain syndrome are many and include an altered bladder lining and possible contribution of a bacterial agent.
Topics: Animals; Autonomic Nervous System; Cystitis, Interstitial; Humans; Urinary Bladder; Urothelium
PubMed: 24412640
DOI: 10.1016/j.autneu.2013.12.005 -
International Journal of Molecular... Jun 2018Current clinical strategies for bladder reconstruction or substitution are associated to serious problems. Therefore, new alternative approaches are becoming more and... (Review)
Review
Current clinical strategies for bladder reconstruction or substitution are associated to serious problems. Therefore, new alternative approaches are becoming more and more necessary. The purpose of this work is to review the state of the art of the current bioengineering advances and obstacles reported in bladder regeneration. Tissue bladder engineering requires an ideal engineered bladder scaffold composed of a biocompatible material suitable to sustain the mechanical forces necessary for bladder filling and emptying. In addition, an engineered bladder needs to reconstruct a compliant muscular wall and a highly specialized urothelium, well-orchestrated under control of autonomic and sensory innervations. Bioreactors play a very important role allowing cell growth and specialization into a tissue-engineered vascular construct within a physiological environment. Bioprinting technology is rapidly progressing, achieving the generation of custom-made structural supports using an increasing number of different polymers as ink with a high capacity of reproducibility. Although many promising results have been achieved, few of them have been tested with clinical success. This lack of satisfactory applications is a good reason to discourage researchers in this field and explains, somehow, the limited high-impact scientific production in this area during the last decade, emphasizing that still much more progress is required before bioengineered bladders become a commonplace in the clinical setting.
Topics: Animals; Bioprinting; Humans; Regeneration; Tissue Engineering; Tissue Scaffolds; Urinary Bladder
PubMed: 29914213
DOI: 10.3390/ijms19061796 -
The British Journal of Radiology Aug 2020The distinction of non-muscle-invasive bladder cancer and muscle-invasive bladder cancer is important for the selection of the optimal treatment. Multiparametric MRI... (Review)
Review
The distinction of non-muscle-invasive bladder cancer and muscle-invasive bladder cancer is important for the selection of the optimal treatment. Multiparametric MRI (mp-MRI) has been an useful modality for the T staging of bladder cancer, and a systematic evaluation of mp-MRI is needed. The Vesical Imaging Reporting and Data System was designed to standardize the scanning and reporting criteria based on mp-MRI for clinical and research applications. This review briefly describes the method, interpretation, and timing of mp-MRI examinations in the clinical settings. Validation studies of Vesical Imaging Reporting and Data System and future perspectives are also considered.
Topics: Humans; Multiparametric Magnetic Resonance Imaging; Neoplasm Staging; Urinary Bladder; Urinary Bladder Neoplasms
PubMed: 32516554
DOI: 10.1259/bjr.20200116 -
Clinical Journal of the American... Mar 2015Urine differs greatly in ion and solute composition from plasma and contains harmful and noxious substances that must be stored for hours and then eliminated when it is... (Review)
Review
Urine differs greatly in ion and solute composition from plasma and contains harmful and noxious substances that must be stored for hours and then eliminated when it is socially convenient to do so. The urinary tract that handles this output is composed of a series of pressurizable muscular compartments separated by sphincteric structures. With neural input, these structures coordinate the delivery, collection, and, ultimately, expulsion of urine. Despite large osmotic and chemical gradients in this waste fluid, the bladder maintains a highly impermeable surface in the face of a physically demanding biomechanical environment, which mandates recurring cycles of surface area expansion and increased wall tension during filling, followed by rapid wall compression during voiding. Afferent neuronal inflow from mucosa and submucosa communicates sensory information about bladder fullness, and voiding is initiated consciously through coordinated central and spinal efferent outflow to the detrusor, trigonal internal sphincter, and external urethral sphincter after periods of relative quiescence. Provocative new findings suggest that in some cases, lower urinary tract symptoms, such as incontinence, urgency, frequency, overactivity, and pain may be viewed as a consequence of urothelial defects (either urothelial barrier breakdown or inappropriate signaling from urothelial cells to underlying sensory afferents and potentially interstitial cells). This review describes the physiologic and anatomic mechanisms by which urine is moved from the kidney to the bladder, stored, and then released. Relevant clinical examples of urinary tract dysfunction are also discussed.
Topics: Humans; Interstitial Cells of Cajal; Muscle Contraction; Muscle, Smooth; Neural Pathways; Ureter; Urethra; Urinary Bladder; Urination; Urothelium
PubMed: 24742475
DOI: 10.2215/CJN.04520413 -
Tidsskrift For Den Norske Laegeforening... May 2020
Topics: Humans; Mental Disorders; Syndrome; Urinary Bladder
PubMed: 32378858
DOI: 10.4045/tidsskr.20.0295