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Archives of Gynecology and Obstetrics

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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

Authors: Ahmed Shafik, Ali A. Shafik, Ismail A. Shafik, Olfat El Sibai

Published in: Archives of Gynecology and Obstetrics | Issue 3/2008

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’.

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

Bell C (1972) Autonomic nervous control of reproduction: circulatory and other factors. Pharmacol Rev 24:657–713PubMed

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

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

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

Janig W, McLachlan EM (1987) Organization of lumbar spinal outflow to the distal colon and pelvic organs. Physiol Rev 67:1332–1404PubMed

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

Masters WH, Johnson VG (1970) Human sexual inadequacy. In: Masters WH, Johnson VG (eds) Little Brown, Boston

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.

Morrison JFB, Spillane K (1986) Neuropharmacological studies on descendin inhibitory controls over micturition reflex. J Auton Nerv Syst, pp 393–396

11.

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.

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.

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.

Shafik A (1993) Vagino–cavernosus reflex. Clinical significance and role in sexual act. Gynecol Obstet Invest 35:114–117PubMedCrossRef

15.

Shafik A (1994) Utero–cervical inhibitory reflex. The description of a reflex and its clinical significance. Human Reprod 9:2220–2223

16.

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.

Shafik A (1995) Vagino–puborectalis reflex. The description of a new reflex and its clinical significance. Int J Gynaecol Obstet 51:61–62PubMedCrossRef

18.

Shafik A (1995) The ‘clitoromotor’ reflex. Int Urogynecol J 6:329–335CrossRef

19.

Shafik A (1996) The cervico-motor reflex. Description of the reflex and role in sexual act. J Sex Res 33:153–157CrossRef

20.

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.

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.

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.

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.

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.

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.

Yokoyama O, Komotso K, Kodama K et al (2000) Diagnostic value of intravesical lidocaine for overactive bladder. J Urol 164:340–343PubMedCrossRef

Title: 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
Authors: Ahmed Shafik
Ali A. Shafik
Ismail A. Shafik
Olfat El Sibai
Publication date: 01-03-2008
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 3/2008
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-007-0456-8

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background/aim

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background/aim

Methods

Results

Conclusion

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