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Acute Oligohydramnios of Renal Origin: A Different Entity?
S32 occur early during fetal life. Prenatal developmental alterations may therefore increase the likelihood of developing
ESPU Meeting 2007 prostate cancer later in life. Hence, prostatic stem cells require further functional investigations to understand
their role in different developmental stages of the prostate.
# S05-3 (PP)
EARLY DEVELOPMENT OF THE URETHRAL SPHINCTER MUSCLE : RELATIONSHIP OF THE STRIATED MUSCLE FIBRES WITH THE PROSTATE IN HUMAN FETUSES Luciano FAVORITO, Waldemar SILVA-COSTA and Francisco SAMPAIO State university from rio de janeiro, anatomy, Rio De Janeiro, BRAZIL
PURPOSE The urethral sphincter muscle has a major hole in the maintenance of urinary continence; its quick voluntary contraction especially during an abrupt interruption of micturition. Our purpose is to describe the arrangement of the striated muscle fibres of the urethral sphincter during gestation and to correlate these finds with those described in grown up prostates.
MATERIAL AND METHODS We analyzed 17 prostates of 17 human fetuses that died of causes unrelated to the urogenital tract. The fetuses were well preserved and none had any kind of detectable congenital malformations.
Gestational age ranged between 10 and 31 weeks post conception (WPC) and was estimated according to foot length criteria. Transverse sections of the prostate were made and stained with Gomori’s trichrome and immunolabeled with anti alpha-actin antibodies.
a ‘‘horseshoe’’ and covers the anterior and lateral sides of the urethra, but not the posterior side. Near the neck of the bladder, we’ve found striated muscle fibres only at the anterior side of prostate, although they could be found at the lateral side of the prostate of the fetus from 20 WPC older.
RESULTS CONCLUSIONS We observed that the urethral sphincter muscle is located on the periphery of the smooth muscle and there wasn’t a mixture between these two types of muscle fibres at any period. In the prostatic apex, the striated sphincter shows a circular arrangement and completely covers the urethra externally; adjacent to the verumontanum, it seems like
The urethral sphincter muscle was present in all fetuses covering the anterior and lateral sides of the urethra. This muscular arrangement is very important in understanding the normal anatomy of the pelvic floor musculature and the alterations of this musculature in congenital anomalies of the genital tract.
# S05-4 (PP)
ACUTE OLIGOHYDRAMNIOS OF RENAL ORIGIN: A DIFFERENT ENTITY? Antonio ZACCARA, Cristina BRISSI*, Laura MOBILI*, Claudio GIORLANDINO*, Irma CAPOLUPOy, Pietro BAGOLAN and Mario DE GENNAROz Opsedale Pediatrico ‘‘Bambino Gesu’’, Newborn Surgery Unit, Department of Neonatology, Rome, ITALY - * Artemisia Medical Center, Fetal Medicine, Rome, ITALY - y Opsedale Pediatrico ‘‘Bambino Gesu’’, Intensive Care Unit, Department of Neonatology, Rome, ITALY - z Opsedale Pediatrico ‘‘Bambino Gesu’’, Urodynamic Unit, Department of Nephrology and Urology, Rome, ITALY
PURPOSE Oligohydramnios (OI) has long been considered a good marker of Urinary Tract Abnormalities (UTA) and, as such, it usually has an early and progressive onset with poor prognosis However no reports exist about an abrupt decrease of Amniotic Fluid (AF) in pregnancies with UTA.
MATERIAL AND METHODS 28 cases of Bilateral Obstructive Uropathy (BOO) were seen at our Institution. All cases had the diagnosis made between 17 and 20 weeks g.a. with bilateral hydro, distended bladder and dilated posterior urethra. Amniotic Fluid Index (AFI) and its variations throughout pregnancy were
recorded at each follow up encounter. Fetuses with OI since diagnosis were excluded from the study as were those with persistently normal AFI.
monolateral reflux. At six months follow up RF is normal in three patients, mildly impaired in one and severely impaired in one.
RESULTS A sudden decrease in AFI (<5th centile) was found in 5 fetuses: this occurred at 31 weeks in 2 fetuses, at 34 weeks in 2 and at 37 weeks in the remaining one.All fetuses were delivered by C- Section: the two fetuses at 31 weeks underwent one amnioinfusion prior to delivery. The urological diagnosis was urethral atresia in one case, posterior urethral valves in three and prunebelly syndrome in one. All patients had dilated ureters on a voiding cystogram with grade V
CONCLUSIONS OI of renal origin may also have a delayed, acute onset which may be speculatively related to a pop off mechanism at the vesico-ureteric junction producing gross reflux. Unlike cases with progressive decline, acute onset OI is not necessarily associated with deterioration of RF later in life and its prognostic value must be evaluated with caution.
ESPU Meeting 2007 prostate cancer later in life. Hence, prostatic stem cells require further functional investigations to understand
their role in different developmental stages of the prostate.
# S05-3 (PP)
EARLY DEVELOPMENT OF THE URETHRAL SPHINCTER MUSCLE : RELATIONSHIP OF THE STRIATED MUSCLE FIBRES WITH THE PROSTATE IN HUMAN FETUSES Luciano FAVORITO, Waldemar SILVA-COSTA and Francisco SAMPAIO State university from rio de janeiro, anatomy, Rio De Janeiro, BRAZIL
PURPOSE The urethral sphincter muscle has a major hole in the maintenance of urinary continence; its quick voluntary contraction especially during an abrupt interruption of micturition. Our purpose is to describe the arrangement of the striated muscle fibres of the urethral sphincter during gestation and to correlate these finds with those described in grown up prostates.
MATERIAL AND METHODS We analyzed 17 prostates of 17 human fetuses that died of causes unrelated to the urogenital tract. The fetuses were well preserved and none had any kind of detectable congenital malformations.
Gestational age ranged between 10 and 31 weeks post conception (WPC) and was estimated according to foot length criteria. Transverse sections of the prostate were made and stained with Gomori’s trichrome and immunolabeled with anti alpha-actin antibodies.
a ‘‘horseshoe’’ and covers the anterior and lateral sides of the urethra, but not the posterior side. Near the neck of the bladder, we’ve found striated muscle fibres only at the anterior side of prostate, although they could be found at the lateral side of the prostate of the fetus from 20 WPC older.
RESULTS CONCLUSIONS We observed that the urethral sphincter muscle is located on the periphery of the smooth muscle and there wasn’t a mixture between these two types of muscle fibres at any period. In the prostatic apex, the striated sphincter shows a circular arrangement and completely covers the urethra externally; adjacent to the verumontanum, it seems like
The urethral sphincter muscle was present in all fetuses covering the anterior and lateral sides of the urethra. This muscular arrangement is very important in understanding the normal anatomy of the pelvic floor musculature and the alterations of this musculature in congenital anomalies of the genital tract.
# S05-4 (PP)
ACUTE OLIGOHYDRAMNIOS OF RENAL ORIGIN: A DIFFERENT ENTITY? Antonio ZACCARA, Cristina BRISSI*, Laura MOBILI*, Claudio GIORLANDINO*, Irma CAPOLUPOy, Pietro BAGOLAN and Mario DE GENNAROz Opsedale Pediatrico ‘‘Bambino Gesu’’, Newborn Surgery Unit, Department of Neonatology, Rome, ITALY - * Artemisia Medical Center, Fetal Medicine, Rome, ITALY - y Opsedale Pediatrico ‘‘Bambino Gesu’’, Intensive Care Unit, Department of Neonatology, Rome, ITALY - z Opsedale Pediatrico ‘‘Bambino Gesu’’, Urodynamic Unit, Department of Nephrology and Urology, Rome, ITALY
PURPOSE Oligohydramnios (OI) has long been considered a good marker of Urinary Tract Abnormalities (UTA) and, as such, it usually has an early and progressive onset with poor prognosis However no reports exist about an abrupt decrease of Amniotic Fluid (AF) in pregnancies with UTA.
MATERIAL AND METHODS 28 cases of Bilateral Obstructive Uropathy (BOO) were seen at our Institution. All cases had the diagnosis made between 17 and 20 weeks g.a. with bilateral hydro, distended bladder and dilated posterior urethra. Amniotic Fluid Index (AFI) and its variations throughout pregnancy were
recorded at each follow up encounter. Fetuses with OI since diagnosis were excluded from the study as were those with persistently normal AFI.
monolateral reflux. At six months follow up RF is normal in three patients, mildly impaired in one and severely impaired in one.
RESULTS A sudden decrease in AFI (<5th centile) was found in 5 fetuses: this occurred at 31 weeks in 2 fetuses, at 34 weeks in 2 and at 37 weeks in the remaining one.All fetuses were delivered by C- Section: the two fetuses at 31 weeks underwent one amnioinfusion prior to delivery. The urological diagnosis was urethral atresia in one case, posterior urethral valves in three and prunebelly syndrome in one. All patients had dilated ureters on a voiding cystogram with grade V
CONCLUSIONS OI of renal origin may also have a delayed, acute onset which may be speculatively related to a pop off mechanism at the vesico-ureteric junction producing gross reflux. Unlike cases with progressive decline, acute onset OI is not necessarily associated with deterioration of RF later in life and its prognostic value must be evaluated with caution.