Urethra/urethral

Reactive arthritis (ReA) develops 1-3 weeks after a bacterial infection in the intestinal tract (diarrhea) and/or urethra (urethritis) or elsewhere due to immune responses. HLA-B27 positive individuals may develop ReA. ReA is an autoimmune disease and consists of sterile axial and/or peripheral articular inflammation, enthesitis and extra-articular manifestations. 

Urethral stricture Fibrosis and scarring of the urethra that results in narrowing of the urethral lumen. 

Lower tract infections include cystitis (bladder), urethritis (urethra), prostatitis (prostate gland), and epididymitis. Upper tract infections (such as pyelonephritis) involve the kidney and are referred to as pyelonephritis. 

The urethral sphincter, a combination of smooth and striated muscles within and external to the urethra, maintains adequate resistance to the flow of urine from the bladder until voluntary voiding is initiated. Normal bladder emptying occurs with opening of the urethra concomitant with a volitional bladder contraction. 

The goal of treatment of SUI is to improve urethral closure by stimulating a-adrenergic receptors in the smooth muscle of the bladder neck and proximal urethra, enhancing supportive structures underlying the urethral epithelium, or enhancing serotonin and norepinephrine effects in the micturition reflex pathways. 

Einally, external urethral sphincter (voluntary sphincter, or rhabdosphincter) is a striated circumscribing structure emanating from the bladder neck and bladder base detrusor through the mid-urethra in the female and intermediate prostatic urethra in the male. While also surrounding Cowper s glands in the male, these rhabdosphincter subunits contract, most likely, only with ejaculation (Hutch, 1972 Elbadawi, 1980), along with simultaneous anal rhabdosphincter, bulbo-cavernosus muscle, and cremaster muscle contractions. 

Suppositories are pharmaceutical dosage forms intended for administration of medicine via the rectum, vagina, or urethra that melt, soften, or dissolve in the body cavity. Rectal and vaginal suppositories are most common but urethral suppositories are sometimes used. Suppositories are indicated for administering drugs to infants and small children, severely debilitated patients, those who cannot take medications orally, and those for whom the parenteral route might be unsuitable. Suppositories are used to administer drugs for either systemic or local application. Local applications include the... 

Male New Zealand rabbits weighing 2-3 kg are eu-thantized under anesthesia and the abdomen is opened to remove the bladder and the urethra. After excess fat and connective tissue is removed, the bladder and the urethra are dissected into dome, trigone and proximal urethral preparations. All strips are cut transversely being approximately 2-6 mm unstretched. 

Andersson et al. (1983) studied the electrically induced relaxation of the noradrenaline contracted isolated urethra from rabbit and man. In rabbits, two circular transverse sections, each 4 mm long, were taken from the middle and upper parts of the urethra. Human urethral preparations were obtained from male patients undergoing cysto-urethrectomy en bloc because of bladder cancer. Rings of tissue were taken from the membranous and supra- and infra-collicular parts of the prostatic urethra. 

Klarskov (1987) studied the non-cholinergic, non-adrenergic inhibitory nerve responses of bladder outlet smooth muscle from female Danish Landrace pigs in vitro. Trigone strips were taken in an oblique direction from the internal urethral orifice and medially to one of the ureteric orifices, bladder neck strips transversal from the posterior half of the borderline between bladder and urethra, and urethral strips longitudinal from the proximal posterior part. 

Incubation period 5-28 days Organism may be detectable within 48 hours after (posure to infected partner Most common-urethra Others-rectum (usually due to rectal intercourse in men who have s ( with men), orophatyn) eye May be asymptomatic (more common in males than females) or minimally symptomatic Urethral discharge (clear to mucopurulent)... 

Lower tract infections include cystitis (bladder), urethritis (urethra), prostatitis (prostate gland), and epididymitis. Upper tract infections (such as pyelonephritis) involve the kidney and are referred to as pyelonephritis. Uncomplicated UTIs are not associated with structural or neurologic abnormalities that may interfere with the normal flow of urine or the voiding mechanism. Complicated UTIs are the result of a predisposing lesion of the urinary tract such as a congenital abnormality or distortion of the urinary tract, a stone, indwelling catheter, prostatic hypertrophy, obstruction, or neurologic deficit that interferes with the normal flow of urine and urinary tract defenses. 

Severe allergic reactions occurred in five patients after the insertion of an intra-urethral lidocaine jelly containing chlorhexidine gluconate and instrumentation of the urethra (54). All had a positive response to chlorhexidine gluconate (0.0005%) and a negative response to lidocaine (0.2%). 

Affinity of selected Oj-AR antagonists for the recombinant animal a,-AR subtypes (pKi= -log,, nM) and functional affinity for the Oj-ARs of vascular and lower urinary tract tissues (pKb= -logj Kb, nM, for inhibition of NA-induced contraction). R.A.= rat aorta RB.A.= rabbit aorta RB.U.= rabbit urethra H.P.=human prostate. The in vivo effects after i.v. administration in the dog model are also listed. Data represent the doses (pg/kg) active in inhibiting by 50% the urethral contractions induced by NA (UP), the doses active in lowering diastolic blood pressure (DBP) by 25%, and the ratio between them. The ratios between the in vitro potency (Kb) on rabbit aorta and urethra are also reported (1/2). 

In this modeL prazosin, terazosin and conq>ound 12 proved devoid of selectivity, t hereas tamsulosin and 5-methylurapidil exhibited limited selectivity. SNAP 5089 showed some selectivity but its potency against the urethral contractile response was imexpectedly very low. On the contrary, the novel N-arylpiperazine derivatives (in particular conq>ounds 4 and 7) were endowed with very high potency and selectivity for the lower urinary tract. Interestingly, a good correlation between the in vitro potency on rabbit urethra and the in vivo potency in inhibiting the urethral contractions induced by La. injection of the agonist in the dog was found (R" = 0.925). 

The urethra can be injured because of improper administration technique. Injuries can lead to urethral stricture and difficulty in voiding. Patients should receive complete education about optimal administration procedures before the start of treatment. 

Urethral pain has been reported in 24% to 32% of patients. Usually it is mild and does not require discontinuation of treatment. Female sexual partners may experience vaginal burning, itching, or pain, which is probably related to transfer of alprostadil from the man s urethra to the woman s vagina during intercourse. However, the resumption of sexual intercourse could also produce such symptoms. 

The lower urinary tract consists of the bladder, urethra, urinary or urethral sphincter, and the surrounding musculofascial structures including connective tissue, nerves, and blood vessels. The urinary bladder is a hollow organ composed of smooth muscle and connective tissue located deep in the bony pelvis in men and women. The urethra is a hollow tube that acts as a conduit for urine flow out of the bladder. The interior surface of both the bladder and urethra is lined by an epithelial cell layer termed transitional epithelium, which is in constant contact with urine. Previously considered inert and inactive, transitional epithelium may actually play an active role in the pathophysiology of many lower urinary tract disorders, including interstitial cystitis and UI. The urinary or urethral sphincter is a combination of smooth and striated muscle within and surrounding the most proximal portion of the urethra adjacent to the bladder in both men and women. This is a functional but not anatomic sphincter that includes a portion of the bladder neck or outlet as well as the proximal urethra. 

Culture is considered the most reliable means of diagnosing gonococcal infections. Anatomic sites to be cultured depend on the individual s sexual preferences and body areas exposed. In women, because the urethra and other sites are rarely the sole locus of infection, cervical cultures produce the highest yield and frequently are performed in conjunction with rectal cultures. Urethral cultures are recommended in women who have had hysterectomies and heterosexual men. In MSM, anorectal cultures generally produce the highest yields, and pharyngeal and urethral cultures are considered optional. ° " ... 

Currently, biopsies of the prostatic urethra are recommended as a staging procedure in patients undergoing intravesical treatment for superficial bladder tumors. If intraductal urothelial carcinoma is identified on TURP or transurethral biopsy, patients will usually be recommended for radical cystoprostatectomy. The finding of intraductal urothelial carcinoma has also been demonstrated to increase the risk of urethral recurrence following cystoprostatectomy, such that its identification may also result in prophylactic total urethrectomy. Immunohistochemical stains for basal cells (high-molecular-weight cytokeratin, p63) may in some cases only outline the prostatic basal cells and in other cases label the intraductal urothelial carcinoma. 

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