Publication: Anatomy of muscle connections in the male urethra and anorectal canal
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Issued Date
2024-06-01
Resource Type
ISSN
14644096
eISSN
1464410X
Scopus ID
2-s2.0-85187142910
Pubmed ID
38456568
Journal Title
BJU International
Volume
133
Issue
6
Start Page
752
End Page
759
Rights Holder(s)
SCOPUS
Bibliographic Citation
BJU International Vol.133 No.6 (2024) , 752-759
Suggested Citation
Muro S., Shoji S., Suriyut J., Akita K. Anatomy of muscle connections in the male urethra and anorectal canal. BJU International Vol.133 No.6 (2024) , 752-759. 759. doi:10.1111/bju.16307 Retrieved from: https://hdl.handle.net/20.500.14740/20477
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Corresponding Author(s)
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Abstract
Objectives: To elucidate the male urethral muscular structure and its relationship with the anorectal canal muscles, as establishing an anatomical foundation for urethral function will contribute to the prevention, diagnosis, and treatment of urinary incontinence. Methods: Eight male cadavers were used. Using a multifaceted approach, we performed macroscopic anatomical examination, histological analysis of wide-range serial sectioning and immunostaining, and three-dimensional (3D) reconstruction from histological sections. In the macroscopic anatomical examination, pelvic halves were meticulously dissected in layers from the medial aspect. In the histological analysis, the tissue, including the urethra and anorectal canal, was serially sectioned in the horizontal plane. The muscular structures were reconstructed and visualised in 3D. Results: The membranous portion of the urethra had three muscle layers: the longitudinal and circular muscles (smooth muscle) and the external urethral sphincter (skeletal muscle). The circular muscle was connected posteriorly to the longitudinal rectal muscle. The external urethral sphincter had a horseshoe shape, with its posterior ends continuing to the external anal sphincter, forming a 3D ring-like sphincter. Conclusion: This study revealed skeletal and smooth muscle connections between the male urethra and anorectal canal, enabling urethral compression and closure. These anatomical muscle connections suggest a functional linkage between them.