Parapodial glandular organs in Owenia borealis (Annelida: Oweniidae) and their possible relationship with nephridia.

Oweniidae is a basal group of recent annelids and nowadays it attracts the attention of researchers of many biological fields. Surprisingly, details of their anatomy, like the adult excretory system, remain obscure. Researchers recently suggested that the paired organs of tubeworms in the family Oweniidae are related to nephridia. In the current study of Owenia borealis adults, we determined that these structures are parapodial glandular organs (PGOs) and are located in the first two segments of adults. The PGOs are complex subepidermal multicellular glands that contain secretory cells, that is, goblet cells, which are differentiated by the type of the producing tube matter. The goblet cells are surrounded by muscles that are used to extrude material stored in the PGO's lumen into the external environment. The anterior pair of PGOs have very well-developed rough endoplasmatic reticulum in the proximal cells, spacious Golgi complexes, numerous nail-shaped microvilli, and apocrine secretory processes in the goblet cells of the distal parts. The posterior pair of PGOs only consists of cells, which probably produce proteinaceous fibrils. We discuss the homology of goblet cells with specific nail-shaped microvilli that produce ß-chitin within annelids. We also discuss the possibility that PGOs and nephridia have a common origin. This study provides new information on the ultrastructure of cells that secrete the organic material used to form the tubes inhabited by tube-dwelling annelids.

Standardized terminology of apical structures in the female pelvis based on a structured medical literature review.

The objectives of this study were to review the published literature and selected textbooks, to compare existing usage to that in Terminologia Anatomica, and to compile standardized anatomic nomenclature for the apical structures of the female pelvis. MEDLINE was searched from inception until May 30, 2017, based on 33 search terms generated by group consensus. Resulting abstracts were screened by 11 reviewers to identify pertinent studies reporting on apical female pelvic anatomy. Following additional focused screening for rarer terms and selective representative random sampling of the literature for common terms, accepted full-text manuscripts and relevant textbook chapters were extracted for anatomic terms related to apical structures. From an initial total of 55,448 abstracts, 193 eligible studies were identified for extraction, to which 14 chapters from 9 textbooks were added. In all, 293 separate structural terms were identified, of which 184 had Terminologia Anatomica-accepted terms. Inclusion of several widely used regional terms (vaginal apex, adnexa, cervico-vaginal junction, uretero-vesical junction, and apical segment), structural terms (vesicouterine ligament, paracolpium, mesoteres, mesoureter, ovarian venous plexus, and artery to the round ligament) and spaces (vesicocervical, vesicovaginal, presacral, and pararectal) not included in Terminologia Anatomica is proposed. Furthermore, 2 controversial terms (lower uterine segment and supravaginal septum) were identified that require additional research to support or refute continued use in medical communication. This study confirms and identifies inconsistencies and gaps in the nomenclature of apical structures of the female pelvis. Standardized terminology should be used when describing apical female pelvic structures to facilitate communication and to promote consistency among multiple academic, clinical, and surgical disciplines.

Review of the effect of 3D medical printing and virtual reality on urology training with 'MedTRain3DModsim' Erasmus + European Union Project

Background/aim: It is necessary to incorporate novel training modalities in medical education, especially in surgical fields, because of the limitations of cadaveric training. Traditional medical education has many drawbacks, such as residency working hour restrictions, patient safety conflicts with the learning needs, and the lack of hands-on workshops. The MedTRain3DModsim Project aimed to produce 3-dimensional (3D) medical printed models, simulations, and innovative applications for every level of medical training using novel worldwide technologies. It was aimed herein to improve the interdisciplinary and transnational approaches, and accumulate existing experience for medical education, postgraduate studies, and specialty training. Materials and methods: This project focused on models of solid organs and the urinary system, including the kidney, prostate, ureter, and liver. With 3D medical printing, it is possible to produce a body part from inert materials in just a few hours with the standardization of medical 3D modeling. Results: The target groups of this project included medical students and residents, graduate students from engineering departments who needed medical education and surgical training, and medical researchers interested in health technology or clinical and surgical an atomy. Conclusion: It was also intended to develop a novel imaging platform for education and training by reevaluating the existing data using new software and 3D modalities. Therefore, it was believed that our methodology could be implemented in all related medical fields.

An illustrated anatomical ontology of the developing mouse lower urogenital tract.

Malformation of the urogenital tract represents a considerable paediatric burden, with many defects affecting the lower urinary tract (LUT), genital tubercle and associated structures. Understanding the molecular basis of such defects frequently draws on murine models. However, human anatomical terms do not always superimpose on the mouse, and the lack of accurate and standardised nomenclature is hampering the utility of such animal models. We previously developed an anatomical ontology for the murine urogenital system. Here, we present a comprehensive update of this ontology pertaining to mouse LUT, genital tubercle and associated reproductive structures (E10.5 to adult). Ontology changes were based on recently published insights into the cellular and gross anatomy of these structures, and on new analyses of epithelial cell types present in the pelvic urethra and regions of the bladder. Ontology changes include new structures, tissue layers and cell types within the LUT, external genitalia and lower reproductive structures. Representative illustrations, detailed text descriptions and molecular markers that selectively label muscle, nerves/ganglia and epithelia of the lower urogenital system are also presented. The revised ontology will be an important tool for researchers studying urogenital development/malformation in mouse models and will improve our capacity to appropriately interpret these with respect to the human situation.

Voiding Dysfunction After Non-urologic Pelvic Surgery.

PURPOSE OF REVIEW: Urinary dysfunction is a common entity in patients undergoing radical pelvic surgery for non-urologic malignancies. These dysfunctions may manifest as lower urinary tract symptoms (LUTS) or signs such as urinary retention or leakage. Review of current literature is performed to describe the differing urinary dysfunctions that manifest after colorectal resection, hysterectomy, and sacrectomy. RECENT FINDINGS: Conventional radical surgery for pelvic malignancies often will result in debilitating functional problems. As advances in surgical techniques and management options become more available, patients can have better functional outcomes, specifically in the lower urinary tract. Nerve-sparing techniques as well as vascular preservation are becoming more important to preserve function as patient survival is improving. Additionally, newer methods are being explored, such as nerve stimulation for those who are unable to empty adequately. This article also addresses different management options for specific voiding dysfunction that may result from pelvic surgery. Preventative strategies such as nerve preservation during surgery are an important concept to prevent urinary dysfunction. The goal to good functional outcomes includes maintaining reservoir compliance and capacity as well as allowing proper outlet for voiding. We discuss different modalities to help achieve a functional lower urinary tract for patients with lower urinary tract dysfunction after pelvic surgery.

Ureter Complications: A Rare Complication but which Requires the Highest Degree of Management Expertise.

INTRODUCTION: 0% of all urinary tract injuries are iatrogenic lesions. Although they only occur in < 5%, they can lead to severe ipsilateral renal dysfunctions. These lesions can be treated with extensive knowledge on the genesis of the lesion, the anatomy, the individual patient's history and high operative expertise in diverse surgical methods. MATERIAL AND METHODS: In this article, we show which reconstruction options are possible, depending on the lesion's severity according to the AAST and EAU Guidelines from 2009 on the classification of ureter injuries, as well as the localisation. A special focus is on the anatomy. It is important to adhere to surgical ground principles, such as making sure all pathological tissue is removed, the ureter ends are spatulated and a tension-free and watertight anastomosis is maintained. RESULTS: Iatrogenic ureter lesions are rare complications, but being able to deal with these frequently requires a urologist's expertise. Whenever surgeons operate close to the ureters, there is always a risk of an iatrogenic ureter lesion, which in turn requires that all available reconstructive measures are used dynamically. CONCLUSION: Ureter complications are rare but require surgeons' excellent management expertise.

Novel Card Games for Learning Radiographic Image Quality and Urologic Imaging in Veterinary Medicine.

Second-year veterinary students are often challenged by concepts in veterinary radiology, including the fundamentals of image quality and generation of differential lists. Four card games were developed to provide veterinary students with a supplemental means of learning about radiographic image quality and differential diagnoses in urogenital imaging. Students played these games and completed assessments of their subject knowledge before and after playing. The hypothesis was that playing each game would improve students' understanding of the topic area. For each game, students who played the game performed better on the post-test than students who did not play that game (all p<.01). For three of the four games, students who played each respective game demonstrated significant improvement in scores between the pre-test and the post-test (p<.002). The majority of students expressed that the games were both helpful and enjoyable. Educationally focused games can help students learn classroom and laboratory material. However, game design is important, as the game using the most passive learning process also demonstrated the weakest results. In addition, based on participants' comments, the games were very useful in improving student engagement in the learning process. Thus, use of games in the classroom and laboratory setting seems to benefit the learning process.

RADIOGRAPHIC AND ULTRASONOGRAPHIC ABDOMINAL ANATOMY IN CAPTIVE RING-TAILED LEMURS (LEMUR CATTA).

The ring-tailed lemur (Lemur catta) is primarily distributed in south and southwestern Madagascar. It is classified as an endangered species by the International Union for Conservation of Nature. Various abdominal diseases, such as hepatic lipidosis, intestinal ulcers, cystitis, urinary tract obstruction, and neoplasia (e.g., colonic adenocarcinoma and cholangiocarcinoma), have been reported in this species. The aim of this study was to describe the normal radiographic and ultrasonographic abdominal anatomy in captive ring-tailed lemurs to provide guidance for clinical use. Radiography of the abdomen and ultrasonography of the liver, spleen, kidneys, and urinary bladder were performed in 13 and 9 healthy captive ring-tailed lemurs, respectively, during their annual health examinations. Normal radiographic and ultrasonographic reference ranges for abdominal organs were established and ratios were calculated. The majority (12/13) of animals had seven lumbar vertebrae. The sacrum had mainly (12/13) three segments. Abdominal serosal detail was excellent in all animals, and hypaxial muscles were conspicuous in the majority (11/13) of animals. The spleen was frequently (12/13) seen on the ventrodorsal (VD) view and rarely (3/13) on the right lateral (RL) view. The liver was less prominent and well contained within the ribcage. The pylorus was mostly (11/13) located to the right of the midline. The right and left kidneys were visible on the RL and VD views, with the right kidney positioned more cranial and dorsal to the left kidney. On ultrasonography, the kidneys appeared ovoid on transverse and longitudinal views. The medulla was hypoechoic to the renal cortex. The renal cortex was frequently (8/9) isoechoic and rarely (1/9) hyperechoic to the splenic parenchyma. The liver parenchyma was hypoechoic (5/5) to the renal cortex. Knowledge of the normal radiographic and ultrasonographic abdominal anatomy of ring-tailed lemurs may be useful in the diagnosis of diseases and in routine health examinations.

Recognition and Management of Urologic Injuries With Laparoscopic Hysterectomy.

Injuries to the urinary tract during laparoscopic hysterectomy are quite rare, but are among the most serious injuries that occur during gynecologic surgery. Injury rates among subtypes of laparoscopic hysterectomy have been found to be similar. The most effective way to avoid urinary tract injury is knowledge of urinary tract anatomy and careful and thoughtful dissection.

Study of the renal segmental arterial anatomy with contrast-enhanced multi-detector computed tomography.

PURPOSE: To use triphasic multi-detector computed tomography (MDCT) to study the renal segmental arterial anatomy and its relationship with the urinary tract to plan nephron-sparing surgery (NSS). METHODS: One hundred and fifty nine patients underwent abdominal contrast-enhanced MDCT. We evaluated renal arteries and parenchymal vasculature. In 61 patients, the arteries and the urinary tract were represented simultaneously. RESULTS: 86.60% presented a single renal artery; 13.4%, multiple arteries. All single renal arteries divided into anterior and posterior branch before the hilum. The anterior artery branched into a superior, middle, and inferior branch. In 43.14%, the inferior artery arose before the others; in 45.75%, the superior artery arose before the others; in 9.80%, the branches shared a common trunk. In 26.80%, the posterior artery supplies the entire posterior surface; in 73.20%, it ends along the inferior calyx. In 96.73%, the upper pole was vascularized by the anterior superior branch and the posterior artery: the "tuning fork". MDCT showed four vascular segments in 96.73% and five in 3.27%. MDCT showed two avascular areas: the first along the projection of the inferior calyx on the posterior aspect, the second between the branches of the "tuning fork". CONCLUSIONS: The arterial phase provides the arterial tree representation; the delayed phase shows arteries and urinary tract simultaneously. MDCT provides a useful representation of the renal anatomy prior to intervascular-intrarenal NSS.

Computed tomography of the abdomen of calves during the first 105 days of life: III. Urinary tract and adrenal glands.

Computed tomographic (CT) findings of the urinary tract and adrenal glands of five healthy male calves in the first 105 days of life were compared with corresponding cadaver slices. The structures seen on CT images were identified using the corresponding cadaver slices. CT produced exact images of the kidneys, urinary bladder, urethra and adrenal glands, but reliable images of the ureters were only obtained near the renal hilus. There was excellent agreement between the structures on the CT images and the tissue slices. The structure and vessels of the kidneys, the origin of the ureters, the location, size and content of the urinary bladder and the course of the urethra in the pelvis and penis were evident on images. The size and volume of the kidneys and the length and width of the adrenal glands increased significantly during the study, but the ureteral and urethral diameters changed little.

Dans le présent travail, on décrit les constatations tomodensitométriques sur l'appareil urinaire et les surrénales de 5 veaux mâles en bonne santé dans les 105 premiers jours de vie et on les compare avec les résultats des examens post-mortem. Il est possible de visualiser exactement les reins, la vessie, l'urètre et les surrénales par tomodensitométrie alors que les uretères ne peuvent être identifiés de façon sûre que dans la zone du hile rénal. La topographie des organes et leur structure correspondent très bien aux coupes anatomiques. Il est possible de visualiser la structure et les vaisseaux des reins, le début des uretères, la position, la taille et le contenu de la vessie et le parcours de l'urètre dans le bassin et le pénis. L'extension et le volume des reins augmentent de façon significative entre le premier et le sixième examen. Il en est de même pour la longueur et la largeur des surrénales, alors que les diamètres des uretères et de l'urètre ne changent presque pas.

A study of the surgical scenario in endourology. The Campos instrument.

OBJECTIVES: A new concept for endoscopy is presented in the form of a ureteroscope and cystoscope that efficiently adapts to the needs and situation of the surgical scenario, both in patient's health benefit and better results, and also physician's wellbeing. METHODS: The concept of the instrument, in the neutral position, gives response to the urinary tract anatomy in supine decubitus: horizontally form side to side. The instrument has a handle with a rotor to control the distal active flexible segment of the shaft. It has a unique new shaft with at least three different elastic properties with a proximal firm first segment, followed by a second passive flexible and a third distal active flexible segment. Two pending US patents and another patent endorse the invention. RESULTS: A perceptive instrument from first contact has been developed. The horizontal response reduces rotation requirements, X-ray needs down to 30 seconds at the most, and operating time to a third. It may be introduced and maneuvered with one hand only, avoiding the need for an assistant and it has the ad vantage that it may be used sitting. CONCLUSIONS: Current operating room scenario generates a demanding situation, affecting even surgeon's own general health. The Campos Instrument has exclusive features for operating room ergonomic fusion, making procedures more dynamic. It simulta-neously procures patient and physician's health. Allows a predictable navigation and provides the stability of a firm endoscope with the diagnostic and therapeutic capabilities of the flexible.

Simulation of the upper urinary system.

The ureter and its peristalsis motions have long been of significant interest in biomechanics. In this article we review experimental, theoretical, and numerical studies of the behavior of the ureter together with its mechanical properties, emphasizing studies that contain information of importance in building a virtual simulation tool of the complete ureter that includes its complex geometry, nonlinear material properties, and interaction with urine flow. A new technique to model the contraction of a ureter, which directly applies wall forces to model pacemaker activities, is presented. The required further steps to capture the full complex movement of the peristalsis are discussed, aiming to construct a computational platform that will provide a reliable tool to assist in the investigation and design of material devices (stents) for the renal system.

Bladder dysfunction in peripheral neuropathies.

Normal bladder function depends on the complex interaction of sensory and motor pathways. Bladder dysfunction can develop as a result of several neurological conditions. It can happen in a number of ways, including diabetic cystopathy, detrusor overactivity, bladder outlet obstruction, and urge and stress urinary incontinence. Diabetic neuropathy is the most common cause of peripheral neuropathy-associated bladder dysfunction. Guillain-Barré syndrome (GBS), human immunodeficiency virus (HIV)-associated neuropathy, chronic inflammatory demyelinating polyneuropathy (CIDP), and amyloid neuropathy are other major causes. The diagnosis of bladder dysfunction should be established by the history of neurological symptoms, neurological examination, and urological evaluation. Functional evaluation of the lower urinary tract includes cystometry, sphincter electromyography, uroflowmetry, and urethral pressure profilometry. Management of urinary symptoms in patients with bladder dysfunction is usually supportive. In some cases, alpha-blocker and/or anti-muscarinic agents are needed to help improve urinary dysfunction. Intermittent self-catheterization is needed occasionally for patients with slow and/or poor recovery.

Proliferative and nonproliferative lesions of the rat and mouse urinary system.

The INHAND Project (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) is a joint initiative of the Societies of Toxicologic Pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP), and North America (STP) to develop an internationally accepted nomenclature for proliferative and nonproliferative lesions in laboratory animals. The purpose of this publication is to provide a standardized nomenclature for classifying lesions observed in the urinary tract of rats and mice. The standardized nomenclature of urinary tract lesions presented in this document is also available electronically on the Internet (http://www.goreni.org/). Sources of material included histopathology databases from government, academia, and industrial laboratories throughout the world. Content includes spontaneous developmental and aging lesions as well as those induced by exposure to test materials. A widely accepted and utilized international harmonization of nomenclature for urinary tract lesions in laboratory animals will decrease confusion among regulatory and scientific research organizations in different countries and provide a common language to increase and enrich international exchanges of information among toxicologists and pathologists.

[The prostate gland: a crossroad between the urinary and the seminal tracts]. / La prostate: une glande au carrefour uro-génital.

The prostate's location at the crossroad between the urethra and ejaculatory ducts could explain her urinary and genital function. The currently anatomical model has been proposed by McNeal et al. in 1968. The prostate gland is divided in 4 zones surrounding the urethra in its vertical path from the bladder to the striated sphincter. Transition, Central and peripheral zones consist of tubulo-alveolar glandular tissue secreting the spermatic fluid while the anterior fibro-muscular zone consists of smooth muscle which may start voiding. The confluence between the urinary and genital tract in the prostate explains the anatomic proximity and the intimate relationship between male genital and urinary organs. Elderly anatomical changes of the prostate may therefore be involved in sexual and urinary symptoms. The development of prostate medications may be effective both on voiding and erectile dysfunction.

Morphology of urinary system in six-banded armadillo (Euphractus sexcinctus, Linnaeus, 1758).

Euphractus sexcinctus is a wild mammal native to the Americas; they have great diversity and are not in danger of extinction like other armadillo species. Despite the diversity, the morphology of several biological systems of this species has not been fully described. This study details the gross and microscopic anatomy of the urinary system in Euphractus sexcinctus, a six-banded armadillo, compared with other mammalian study models. Six animals were dissected in the study. In the anatomical analysis, the kidneys, ureters, urinary bladder and urethra were dissected and photographed; then, fragments were submitted to histological routine for staining with haematoxylin-eosin, toluidine blue and Masson's trichrome for visualization under light microscopy. The six-banded armadillo ureter is histologically composed of four concentric layers. The urinary bladder is presented with three tissue layers. The pattern of constitution and distribution of urinary system structures was compatible with that of most domestic like Canis familiaris and wild animals like Bradypus torquatus, with adaptations for the arid and semi-arid habitat. The description of the morphology of Euphractus sexcinctus presents great relevance both for its conservation and for its use as a model for clinical research.

Computed tomography of the abdomen in Saanen goats: III. kidneys, ureters and urinary bladder.

This study describes the findings of computed tomography (CT) of the kidneys, ureters, urinary bladder and adrenal glands in 28 healthy female Saanen goats. CT examination and anatomical slice preparation postmortem was performed as described in the first communication. After subjective evaluation of the CT images, various variables including the size, volume and density of the kidneys, the diameter of the ureters and the size of the adrenal glands were measured. The targeted organs could be accurately visualised using CT and there was very good topographical agreement between the CT images and the anatomical preparations. The kidneys, renal vessels, ureters, urinary bladder and adrenal glands were seen in all goats.

Mechanisms of action of sacral neuromodulation.

The lower urinary tract dysfunction encompasses voiding, postvoiding, and storage symptoms. Conventional treatment modalities include pharmacotherapy and behavioural therapy. Sacral neuromodulation (SNM) is a safe and minimally invasive treatment modality that has recently gained wide acceptance in the management of urinary urge incontinence, urge frequency, and nonobstructive urinary retention, in particular, among those patients with conditions refractory to conventional methods. We searched multiple electronic databases through June 30, 2009 for eligible studies. We examined published clinical and experimental studies concerning the mechanisms of action of SNM. In the first part of the manuscript, we describe the anatomy and functions of the lower urinary tract including the reflexes involved in its functions and then review the pathophysiology of major types of the lower urinary tract dysfunction. In the second part, we discuss different ways for SNM to control various types of voiding dysfunction. The lower urinary tract dysfunctions affect millions of people worldwide and have a severe impact on their quality of life. SNM offers a safe and minimally invasive modality in the treatment of voiding dysfunctions, especially in patients with conditions refractory to conventional therapies.