Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 3/2008

01.03.2008 | Original Article

The electromyographic activity of the external and internal urethral sphincters and urinary bladder on vaginal distension and its role in preventing vaginal soiling with urine during sexual intercourse

verfasst von: Ahmed Shafik, Ali A. Shafik, Ismail A. Shafik, Olfat El Sibai

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 3/2008

Einloggen, um Zugang zu erhalten

Abstract

Background/aim

We investigated the hypothesis that external (EUS) and internal (IUS) urethral sphincters and urinary bladder (UB) respond to penile thrusting (PT) of vagina in a way that prevents urinary leakage during coitus.

Methods

Vaginal condom was inflated with air in increments of 50–300 ml and EMG of EUS and IUS and vaginal pressure were recorded; test was repeated after anesthetization of vagina, UB, EUS, and IUS.

Results

Vaginal distension effected reduction of vesical pressure but increase of IUS EMG until the 150 ml distension was reached, beyond which more vaginal distension caused no further effect; EUS EMG showed no response. Vaginal distension while vagina, UB, EUS, and IUS had been separately anesthetized, produced no change.

Conclusion

Vaginal balloon distension appears to effect vesical relaxation and increased IUS tone. This seems to provide a mechanism to avoid urine leakage during coitus and to occur through a reflex we term ‘vagino-urethrovesical reflex’.
Literatur
1.
Zurück zum Zitat Bancroft J (1989) The biological basis of human sexuality. In: Bancroft J (ed) Human sexuality and its problems, 2nd edn. Churchill Livingstone, London, p 63 Bancroft J (1989) The biological basis of human sexuality. In: Bancroft J (ed) Human sexuality and its problems, 2nd edn. Churchill Livingstone, London, p 63
2.
Zurück zum Zitat Bell C (1972) Autonomic nervous control of reproduction: circulatory and other factors. Pharmacol Rev 24:657–713PubMed Bell C (1972) Autonomic nervous control of reproduction: circulatory and other factors. Pharmacol Rev 24:657–713PubMed
3.
Zurück zum Zitat Bors E, Comarr AE (1960) Neurological disturbances of sexual function with special reference to 629 patients with spinal cord injury. Urol Surv 10:191–222 Bors E, Comarr AE (1960) Neurological disturbances of sexual function with special reference to 629 patients with spinal cord injury. Urol Surv 10:191–222
4.
Zurück zum Zitat Guyton AC (1997) Female physiology before pregnancy and the female hormones. In: Guyton AC (ed) Human physiology and mechanisms of disease, 6th edn. WB Saunders, Philadelphia, pp 629–639 Guyton AC (1997) Female physiology before pregnancy and the female hormones. In: Guyton AC (ed) Human physiology and mechanisms of disease, 6th edn. WB Saunders, Philadelphia, pp 629–639
5.
Zurück zum Zitat Hald T, Bradley WE (1982) Neuroanatomy. In: Hald T, Bradley WE (eds) The urinary bladder: neurology and dynamics. Williams and Wilkins, Baltimore, pp 5–21 Hald T, Bradley WE (1982) Neuroanatomy. In: Hald T, Bradley WE (eds) The urinary bladder: neurology and dynamics. Williams and Wilkins, Baltimore, pp 5–21
6.
Zurück zum Zitat Janig W, McLachlan EM (1987) Organization of lumbar spinal outflow to the distal colon and pelvic organs. Physiol Rev 67:1332–1404PubMed Janig W, McLachlan EM (1987) Organization of lumbar spinal outflow to the distal colon and pelvic organs. Physiol Rev 67:1332–1404PubMed
7.
Zurück zum Zitat Janig W (1996) Behavioral and neurovegetative components of reproductive functions. In: Gregor R, Windhorst U (eds) Comprehensive human physiology: from cellular mechanisms to integration, vol 2. Springer, Berlin, pp 2253–2263 Janig W (1996) Behavioral and neurovegetative components of reproductive functions. In: Gregor R, Windhorst U (eds) Comprehensive human physiology: from cellular mechanisms to integration, vol 2. Springer, Berlin, pp 2253–2263
8.
Zurück zum Zitat Masters WH, Johnson VG (1970) Human sexual inadequacy. In: Masters WH, Johnson VG (eds) Little Brown, Boston Masters WH, Johnson VG (1970) Human sexual inadequacy. In: Masters WH, Johnson VG (eds) Little Brown, Boston
9.
Zurück zum Zitat Morris JL, Gibbins IL (1992) Co-transmission and neuromodulation. In: Burnstock G, Hoyle CHV (eds) Autonomic neuroeffector mechanism. Harwood Academic, Chur, Switzerland, pp 33–119 Morris JL, Gibbins IL (1992) Co-transmission and neuromodulation. In: Burnstock G, Hoyle CHV (eds) Autonomic neuroeffector mechanism. Harwood Academic, Chur, Switzerland, pp 33–119
10.
Zurück zum Zitat Morrison JFB, Spillane K (1986) Neuropharmacological studies on descendin inhibitory controls over micturition reflex. J Auton Nerv Syst, pp 393–396 Morrison JFB, Spillane K (1986) Neuropharmacological studies on descendin inhibitory controls over micturition reflex. J Auton Nerv Syst, pp 393–396
11.
Zurück zum Zitat Papka RE, Traurig HH (1993) Autonomic efferent and visceral sensory innervation of the female reproductive system: special reference to neurochemical markers in nerves and ganglionic connections. In: Maggi CA (ed) Nervous control of the urogenital system. Harwood Academic, Chur, Switzerland, pp 423–466 Papka RE, Traurig HH (1993) Autonomic efferent and visceral sensory innervation of the female reproductive system: special reference to neurochemical markers in nerves and ganglionic connections. In: Maggi CA (ed) Nervous control of the urogenital system. Harwood Academic, Chur, Switzerland, pp 423–466
12.
Zurück zum Zitat Pohl CR, Knobil E (1982) The role of the central nervous system in the control of ovarian function in higher primates. Annu Rev Physiol 44:583–593PubMedCrossRef Pohl CR, Knobil E (1982) The role of the central nervous system in the control of ovarian function in higher primates. Annu Rev Physiol 44:583–593PubMedCrossRef
13.
Zurück zum Zitat Shafik A (1993) The cervico–cavernosus reflex. Description of the reflex and its role in the sexual act. Int Urogynecol J 4:70–73CrossRef Shafik A (1993) The cervico–cavernosus reflex. Description of the reflex and its role in the sexual act. Int Urogynecol J 4:70–73CrossRef
14.
Zurück zum Zitat Shafik A (1993) Vagino–cavernosus reflex. Clinical significance and role in sexual act. Gynecol Obstet Invest 35:114–117PubMedCrossRef Shafik A (1993) Vagino–cavernosus reflex. Clinical significance and role in sexual act. Gynecol Obstet Invest 35:114–117PubMedCrossRef
15.
Zurück zum Zitat Shafik A (1994) Utero–cervical inhibitory reflex. The description of a reflex and its clinical significance. Human Reprod 9:2220–2223 Shafik A (1994) Utero–cervical inhibitory reflex. The description of a reflex and its clinical significance. Human Reprod 9:2220–2223
16.
Zurück zum Zitat Shafik A (1995) Vagino-levator reflex: description of a reflex and its role in sexual performance. Eur J Obstet Gynecol Reprod Biol 60:161–164PubMedCrossRef Shafik A (1995) Vagino-levator reflex: description of a reflex and its role in sexual performance. Eur J Obstet Gynecol Reprod Biol 60:161–164PubMedCrossRef
17.
Zurück zum Zitat Shafik A (1995) Vagino–puborectalis reflex. The description of a new reflex and its clinical significance. Int J Gynaecol Obstet 51:61–62PubMedCrossRef Shafik A (1995) Vagino–puborectalis reflex. The description of a new reflex and its clinical significance. Int J Gynaecol Obstet 51:61–62PubMedCrossRef
18.
Zurück zum Zitat Shafik A (1995) The ‘clitoromotor’ reflex. Int Urogynecol J 6:329–335CrossRef Shafik A (1995) The ‘clitoromotor’ reflex. Int Urogynecol J 6:329–335CrossRef
19.
Zurück zum Zitat Shafik A (1996) The cervico-motor reflex. Description of the reflex and role in sexual act. J Sex Res 33:153–157CrossRef Shafik A (1996) The cervico-motor reflex. Description of the reflex and role in sexual act. J Sex Res 33:153–157CrossRef
20.
Zurück zum Zitat Shafik A (1999) A study on the continence mechanism of the external urethral sphincter with identification of the “voluntary urinary inhibition reflex”. J Urol 162:1967–1971PubMedCrossRef Shafik A (1999) A study on the continence mechanism of the external urethral sphincter with identification of the “voluntary urinary inhibition reflex”. J Urol 162:1967–1971PubMedCrossRef
21.
Zurück zum Zitat Shafik A, Sibai O (2001) Effect of vaginal distension on vesicourethral function with identification of the vagino–vesicourethral reflex. J Urol 165:887–889PubMedCrossRef Shafik A, Sibai O (2001) Effect of vaginal distension on vesicourethral function with identification of the vagino–vesicourethral reflex. J Urol 165:887–889PubMedCrossRef
22.
Zurück zum Zitat Silva C, Ribeiro ML, Cruz F (2002) The effect of intravesical resininferatoxin in patients with idiopathic detrusor instability suggests that involuntary detrusor contractions are triggered by C-fiber input. J Urol 168:575–579PubMedCrossRef Silva C, Ribeiro ML, Cruz F (2002) The effect of intravesical resininferatoxin in patients with idiopathic detrusor instability suggests that involuntary detrusor contractions are triggered by C-fiber input. J Urol 168:575–579PubMedCrossRef
23.
Zurück zum Zitat Steers WD (1998) Physiology and pharmacology of the bladder and urethra. In: Walsh PC, Retik AB, Vaughan ED, Wein AJ (eds) Campbell’s urology, 7th edn. WB Saunders, Philadelphia, pp 870–915 Steers WD (1998) Physiology and pharmacology of the bladder and urethra. In: Walsh PC, Retik AB, Vaughan ED, Wein AJ (eds) Campbell’s urology, 7th edn. WB Saunders, Philadelphia, pp 870–915
24.
Zurück zum Zitat Traurig HH, Papka RE (1993) Autonomic efferent and visceral sensory innervation of the female reproductive system: special reference to the functional roles of nerves in reproductive organs. In: Maggi CA (ed) Nervous control of the urogenital system. Harwood Academic, Chur, Switzerland, pp 103–141 Traurig HH, Papka RE (1993) Autonomic efferent and visceral sensory innervation of the female reproductive system: special reference to the functional roles of nerves in reproductive organs. In: Maggi CA (ed) Nervous control of the urogenital system. Harwood Academic, Chur, Switzerland, pp 103–141
25.
Zurück zum Zitat Warwick R, Williams PL (1975) Productive organs of the female. In: Warwick R, Williams PL (eds) Gray’s anatomy, 35th edn. Longman, London, pp 1351–1363 Warwick R, Williams PL (1975) Productive organs of the female. In: Warwick R, Williams PL (eds) Gray’s anatomy, 35th edn. Longman, London, pp 1351–1363
26.
Zurück zum Zitat Yokoyama O, Komotso K, Kodama K et al (2000) Diagnostic value of intravesical lidocaine for overactive bladder. J Urol 164:340–343PubMedCrossRef Yokoyama O, Komotso K, Kodama K et al (2000) Diagnostic value of intravesical lidocaine for overactive bladder. J Urol 164:340–343PubMedCrossRef
Metadaten
Titel
The electromyographic activity of the external and internal urethral sphincters and urinary bladder on vaginal distension and its role in preventing vaginal soiling with urine during sexual intercourse
verfasst von
Ahmed Shafik
Ali A. Shafik
Ismail A. Shafik
Olfat El Sibai
Publikationsdatum
01.03.2008
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 3/2008
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-007-0456-8

Weitere Artikel der Ausgabe 3/2008

Archives of Gynecology and Obstetrics 3/2008 Zur Ausgabe

Hirsutismus bei PCOS: Laser- und Lichttherapien helfen

26.04.2024 Hirsutismus Nachrichten

Laser- und Lichtbehandlungen können bei Frauen mit polyzystischem Ovarialsyndrom (PCOS) den übermäßigen Haarwuchs verringern und das Wohlbefinden verbessern – bei alleiniger Anwendung oder in Kombination mit Medikamenten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

22.04.2024 DGIM 2024 Kongressbericht

Durch die Häufung nach der COVID-19-Pandemie sind Infektionen mit dem Respiratorischen Synzytial-Virus (RSV) in den Fokus gerückt. Fachgesellschaften empfehlen eine Impfung inzwischen nicht nur für Säuglinge und Kleinkinder.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.