Coexistence of fast and slow myosin isozymes in human external urethral sphincter. A preliminary report

Age effects on urethral striated muscle. I. Changes in number and diameter of striated muscle fibers in the ventral urethra

OBJECTIVE

This study was undertaken to test the null hypothesis that the number of striated muscle fibers in the ventral wall of the female urethra remains constant with increasing age.

STUDY DESIGN

The urethra and surrounding tissues from 25 female cadavers, mean age 52 years (+/-SD 18, range 15-80 years), were selected for this study. Each specimen was divided along the midsagittal plane, and a Masson trichrome histologic section was prepared. A systematic count of striated muscle fibers in the ventral wall was then obtained at each decile of urethral length.

RESULTS

A decrease in the total number of fibers within the sampled area was found with increasing age. The mean of the total fibers across all urethrae was 17,423 (+/-SD 9,624, range 4,788-35,867). Over the life span, an average of 364 fibers (2%) were lost per year (95% CI 197-531; P <.001). Mean fiber density was 671 (+/- SD 296, range 228-1374) fibers/mm2 and decreased by 13 fibers/mm2 per year (95% CI 8-17; P <.001). The mean lesser fiber diameter was 24 microm and did not change significantly with age ( P =.3).

CONCLUSIONS

The number and density of urethral striated muscle fibers decline with age.

Immunohistochemical and ultrastructural study of rhabdosphincter component of the prostatic capsule

PURPOSE

There has been no complete agreement on functional anatomy of muscular components of the urethral sphincteric mechanism, particularly in the male patient. The prostatic capsule was studied to define its histological structure and to determine whether its rhabdosphincter component (prostatocapsular rhabdosphincter) consists only of slow twitch or slow and fast twitch striated myofibers.

MATERIALS AND METHODS

We studied 11 whole prostates, including 1 obtained at autopsy and 10 by radical prostatectomy. Samples of prostatic capsule from 4 operative specimens were studied by electron microscopy. Whole mount paraffin sections from transverse slices of the remaining 7 prostates were double labeled with avidin biotin conjugate immunostaining using the primary monoclonal antibodies anti-alpha smooth muscle actin plus anti-alpha sarcomeric actin (all striated myofibers) or antiskeletal myosin fast (fast myofibers only). Tissue components of the prostatic capsule, including smooth muscle and slow versus fast twitch striated myofibers, were quantified by computerized image analysis.

RESULTS

The prostatic capsule consisted of collagen, smooth muscle and striated myofibers. It varied in thickness and proportion of the 3 components among specimens, and in each in relation to transverse circumferential aspect and craniocaudal (horizontal) level of the prostate. Collagen and smooth muscle were equally important components. Striated muscle elements within the capsule consisted of fast twitch and dominant slow twitch myofibers, and were much more abundant in the caudal (distal, lower) than the cranial (proximal, upper) half of the capsule, where they were deficient ventrally (anteriorly) and dorsally (posteriorly). The prostatocapsular rhabdosphincter thus had a butterfly-like appearance, with a thick posteriorly open ring at the apex and 2 thinner, divergent leaflets tapering toward the base at the bladder neck. The fast myofiber population decreased progressively from apex to base of prostate.

CONCLUSIONS

Proof is provided for mixed slow and fast twitch myofiber structure of the prostatocapsular component of human male rhabdosphincter. Sustained (tonic) contraction of slow myofibers probably reinforces the role of urethral smooth muscle in maintaining continence during bladder filling. Swift contraction of fast myofibers that abound caudally in the capsule probably supplements urethral closure by the bulkier membranous urethral part of the rhabdosphincter in preventing leakage of urine under stress when voiding is imminent or willfully withheld.

Functional anatomy of the organs of micturition

The anatomy of the organs of micturition has been the subject of study for nearly 150 years. As a result of advances in techniques and methods of clinical and research investigation, studies over the past three decades have intensified and have been increasingly directed at the functional implications and significance of organ anatomy and structure. This has led to revision of many traditional ideas about micturition and the development of new viewpoints and modalities for study of its disorders. This article summarizes the evolution of our thinking and understanding of the functional anatomy of the bladder and urethra over the years, and suggests possible directions for continued clinical study and investigation.

The proportions of fiber types in human external urethral sphincter: electrophoretic analysis of myosin

The proportions of fast and slow myosin molecules in external urethral sphincter specimens from ten urodynamically normal male bladder carcinoma patients were estimated from the contents of fast and slow myosin light chains in two-dimensional electrophoretic gels. The percentages of fast and slow myosin molecules ranged from 5.0% to 61.4% with a mean of 35.5% and from 38.6% to 95.0% with a mean of 65.5% respectively. It is therefore concluded that the human external urethral sphincter is composed of both fast and slow muscle fibers as well as other voluntary muscles. The human external urethral sphincter is considered to be a highly fatigue-resistant muscle with a very high proportion of slow muscle fibers. In the cases studied so far, there is a great diversity in the proportions of fast and slow myosin molecules; the reason for this remains unknown.