M. J. B. C. Girão

Effect of Estrogen–Progestogen Hormonal Replacement Therapy on Periurethral and Bladder Vessels

Abstract: This study assessed the effect of hormone replacement therapy using estrogens and/or progestogens on the number of vessels in the proximal and distal urethra, vesicourethral junction and bladder of castrated adult female rats. Forty-five virgin adult rats (Rattus norvegicus albinus) castrated for at least 30 days were used. They were assigned to five groups; group I (control) received no medication; the others received via the subcutaneous route, respectively, 17-β-estradiol (group II), medroxyprogesterone acetate (group III), a maize oil and benzyl acid solution – placebo (group IV) and 17-β-estradiol combined with medroxyprogesterone acetate (group V), for a minimum of 28 days. Increased vascularization throughout the urinary tract, except in the distal urethra, was found following estrogen replacement alone. In the group that received combined estrogens and progestogens, no increase was found. It was concluded that estrogen replacement in castrated rats significantly increased the number of vessels in the lower urinary tract.

The impact of pregnancy and childbirth in the urethra of female rats

The aim of this study was to evaluate the modifications in the amount of collagen, muscular, and elastic fibers in the mid-urethra of adult female rats during the pregnancy and after the natural childbirth, cesarean, and after simulated trauma of childbirth. The authors evaluated the histomorphometric aspects (collagen, muscular, and elastic fibers) in the mid-urethra of 70 animals distributed in seven groups: group 1 (n = 10)—control, group 2 (n = 10)—pregnant female rats, group 3 (n = 10)—female rats submitted to cesarean, group 4 (n = 10)—female rats with natural childbirth, group 5 (n = 10)—virgin female rats with simulated trauma of childbirth, group 6 (n = 10)—female rats submitted to cesarean followed by simulation of childbirth trauma, and group 7 (n = 10)—female rats with natural childbirth followed by simulation of childbirth trauma. The average concentration of collagen and elastic fibers and the collagen/muscular fiber correlation in groups 1, 2, and 3 were similar and significantly inferior to groups 4, 5, 6, and 7. The average of muscular fibers was similar in groups 1, 2, and 3 and significantly superior to groups 4, 5, 6, and 7. Pregnancy and cesarean did not induce alterations in collagen, muscular, and elastic fibers. However, the vaginal delivery and simulation of childbirth trauma determined the decrease in muscular fibers and the increase in collagen and elastic fibers and the correlation collagen/muscular fiber.

Impact of pregnancy and childbirth on female rats’ urethral nerve fibers

This study aims to evaluate the urethral nerve fibers of adult female rats during pregnancy and after vaginal birth, cesarean section or simulated birth trauma. For immunohistochemical analysis of nerve fibers, 70 female rats were distributed in seven groups of ten female rats: group 1, control; group 2, pregnant; group 3, cesarean section; group 4, vaginal birth; group 5, virgin female rats with simulated birth trauma; group 6, cesarean section followed by simulation of birth trauma; and group 7, vaginal birth followed by simulation of birth trauma. The number of nerve fibers in groups 1, 2, and 3 were significantly higher than the other groups. Pregnancy and cesarean section did not cause alterations in the nerve fibers number. Vaginal birth and simulated birth trauma significantly decreased the number of nerve fibers in the female rats’ middle urethra.

Changes in the Lower Urinary Tract in Continent Women and in Women with Stress Urinary Incontinence, According to Menopausal Status

Abstract: The aim of this study was to assess the impact of the postmenopausal period on clinical and urodynamic parameters and on the mobility of the bladder neck in continent women and in women with stress urinary incontinence. Fifty-seven postmenopausal women were studied: 30 were continent and 27 had stress urinary incontinence. They were subdivided according to postmenopausal stage into groups A (<5 years) and B (>5 years). Five years was a good marker to separate those women with mild and severe estrogen deficiency. Fifteen premenopausal incontinent women were selected for bladder neck ultrasound as controls. All underwent history, general physical and gynecologic examinations, LH and FSH determinations, type 1 urine and uroculture, circadian voiding diary, cotton-swab test, bladder neck ultrasound and urodynamic investigations. Analysis of the voiding diaries revealed a higher frequency of daytime micturition in both groups of incontinent patients than in the continent ones. Increased bladder neck mobility was also found, both in the cotton-swab test and an ultrasound, in group A and an ultrasound in the premenopausal incontinent women. Urodynamic investigation showed decreased bladder capacity at the first micturition urge, as well as decreased urinary volume in the group A patients compared to the continent ones. Decreased urethral closure maximum pressure was also found in group B patients in relation to the continent ones. We concluded that the effect of hypoestrogenism, manifested postmenopause, causes changes in the lower urinary tract of women, particularly those who are incontinent.

Clinical and urodynamic evaluation in women with stress urinary incontinence treated by periurethral collagen injection

OBJECTIVE To evaluate the success of treatment with periurethral collagen injections in patients suffering from stress urinary incontinence (SUI) with bladder neck hypermobility and intrinsic sphincter deficiency. MATERIALS AND METHODS Forty women suffering from (SUI) were selected and divided into GI (consisting of 13 women with SUI and bladder neck hypermobility) and GII (consisting of 27 women with SUI and intrinsic sphincter deficiency). Periurethral collagen was injected followed by a subjective evaluation (the need for urinary protectors) and an objective evaluation through urodynamic study before and after the treatment. RESULTS It was noticed that after 9 months there was a decrease in the need of urinary protectors in the two groups. It was observed through the urodynamic study that either cure or improvement was achieved in 46% in GI and 40.7% in GII. There was a significant increase in the leak pressure in GII. Moreover, there was a decrease in the volume of urine leak in the two groups, being the results in GII statistically significant. CONCLUSIONS It was concluded that the periurethral collagen injection is useful for the treatment of the SUI. The results in hypermobility are similar to those in intrinsic sphincter deficiency. In fact, it is a very simple out patients procedure, with little side effects.

Teratoma congênito de orofaringe: relato de caso

Oropharyngeal teratoma is the most rare type of teratoma, with only 2% of fetal teratomas. The diagnosis must be established as early as possible, preferably during the prenatal period. The prognosis will depend on the size and location of the lesion, growth rate of the lesion, degree of intracranial spread, its resectability, and immediate care at birth by a multisciplinary team. We report aparticular case of congenital oropharyngeal teratoma (epignathus). The diagnosis was made during the prenatal period by ultrasound, and the fetus evolved to intrauterine death at the 29th week. The anatomopathological examination revealed a female fetus, compatible with 27-28 weeks, oropharyngeal teratoma and congenital malformations.

Histomorphometric analysis of a rat bladder after electrical stimulation.

OBJECTIVE We sought to analyze the effects of electrical stimulation (ES) of the pelvic floor on the bladder of rats. METHODS Forty rats were studied and divided into the following groups: GI (control group) - did not receive ES, GII (placebo) - did not receive ES but had an electrode inserted into the vagina; GIII - underwent six sessions of ES of the pelvic floor and GIV - rats that underwent 12 sessions of ES. Subsequently, the bladder was removed and the epithelium, muscle and blood vessels were analyzed. RESULTS The muscle wall in GIV had increased thickness when compared to other groups. Further, the number of blood vessels was similar in GIII and GIV, which was higher than that found in GI and GII. Finally, there was an increase in the relative percentage of muscle fibers in relation to collagen for GIV compared to GI. CONCLUSION After 12 sessions of ES in rats the muscle layer, the number of blood vessels and the relative percentage of muscle fibers were increased.

A comparative study of lysosomes in infiltrative ductal carcinoma of the breast

analyzed statistically using the Mann-Whitney Utest, with the levels of significance set at P < 0.05. Since lysosomal enzymes are known to be involved in the process of tumor invasion, we felt that their study in carcinoma of the breast would be of interest. We compared the number of lysosomes visualized by Gomori’s method [3] with menopausal status and with the presence of hormonal receptors. When each parameter was analyzed individually, no relationship was detected between lysosome number and the presence or absence of estradiol and progesterone receptors, and no relationship was found in relation to menopausal status. These findings suggest that the mechanism of hormonal control of lysosomal enzyme production may no longer exist in cancerous tissue, in contrast with the mechanisms which occur in normal breast