Coexistence of Elastic Fibers with Hyaluronic Acid in the Human Urethral Sphincter Complex: A Histological Study
Coexistence of Elastic Fibers with Hyaluronic Acid in the Human Urethral Sphincter Complex: A Histological Study
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DOI：
10.1016/j.juro.2013.04.023
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发表时间：
2013-10-01
影响因子：
6.6
通讯作者：
Takenaka, Atsushi
中科院分区：
文献类型：
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作者：
Hinata, Nobuyuki;Murakami, Gen;Takenaka, Atsushi
目的：为了促进尿道括约肌功能障碍的预防和治疗，我们检查了尿道括约肌复合体周围弹性纤维的分布以及与弹性纤维结构相关的透明质酸的组织学定位。材料和方法：使用elastica-Masson染色以及生物素化透明质酸结合蛋白，我们检查了从14名日本老年人获得的尿道括约肌复合体标本尸体包括10名男性和4名女性。作为对照，我们还观察了男性尸体中的其他横纹肌。结果：弹性纤维密集分布在男性尿道全长（包括前列腺尿道）的粘膜下层和平滑肌层中。肛提肌筋膜和横纹括约肌也含有丰富的弹性纤维。在横纹括约肌中观察到肌内弹性网，但在其他横纹肌中未观察到。透明质酸的强染色在尿道的粘膜下层和平滑肌括约肌中很明显，但在肛提肌筋膜或横纹肌括约肌中却没有，这表明弹性纤维和透明质酸可能在以前的部位相互作用。弹力纤维和透明质酸分布存在性别差异，女性弹力纤维密度和透明质酸染色明显低于男性。结论：尿道弹力纤维和透明质酸共存部位可作为预防和治疗尿道括约肌功能不全的靶点。这些发现应该可以提高我们对人类尿道括约肌复合体的理解。
Purpose: To promote the prevention and treatment of urethral sphincteric dysfunction, we examined the distribution of elastic fibers around the urethral sphincter complex and the histological localization of hyaluronic acid in relation to elastic fiber architecture.Materials and Methods: Using elastica-Masson staining as well as biotinated hyaluronic acid binding protein, we examined specimens of the urethral sphincter complex obtained from 14 elderly Japanese cadavers, including 10 men and 4 women. As a control, we also observed other striated muscles in male cadavers.Results: Elastic fibers were densely distributed throughout the submucosal and smooth muscle layers along the entire length of the male urethra, including the prostatic urethra. The levator ani fascia and rhabdosphincter also contained abundant elastic fibers. An intramuscular elastic net was seen in the rhabdosphincter but not in other striated muscles. Strong staining for hyaluronic acid was evident in the submucosa and smooth muscle sphincter of the urethra but not in the levator ani fascia or rhabdosphincter, suggesting that elastic fibers and hyaluronic acid might interact at the former sites. Gender related differences in the distribution of elastic fibers and hyaluronic acid were noted with a much lower density of elastic fibers and hyaluronic acid staining in women than in men.Conclusions: Urethral sites where elastic fibers and hyaluronic acid coexist could be targeted for the prevention and treatment of urethral sphincteric insufficiency. These findings should improve our understanding of the human urethral sphincter complex.