Outlet Control, Pathogenesis, and Treatment: The Role of Ultrasound in Its Management

@article{Hemaly2018OutletCP,
  title={Outlet Control, Pathogenesis, and Treatment: The Role of Ultrasound in Its Management},
  author={A. El Hemaly and Ibrahim Mahrous Kandil and Laila A. Mousa and Abdel Aa Aldarwish and Muhammad R. Morad and Mervat M. Ibrhaim and Mahmoud Eledaisy and Khaled A. Ali Shehata and Mona M. Ragab},
  journal={Donald School Journal of Ultrasound in Obstetrics \& Gynecology},
  year={2018},
  volume={12},
  pages={4-12}
}
Introduction: Outlet control means continence, which is how to control body excreta (urine, flatus, and feces), control of temperance, body reaction, and control of sexual behavior and premature ejaculation. It is a nerve–muscle action, controlled by the central nervous system (CNS). Outlet control is an acquired behavior gained by learning and training to control the sympathetic nervous system. Although the sympathetic nervous system is part of the involuntary autonomic nervous system control… 

Micturition and Defecation, Neuro-Chemical Control

TLDR
The urinary bladder and the urethra; the rectum and the anal canal have the same embryologic anatomical source, from the cloaca, and have systemic sensory and proprioceptors in the muscle responsive to mechanical changes.

Voiding Troubles, Fecal Incontinence and Anal Intercourse

TLDR
Voiding (urine &/or feces) depends on: Toilet training early in life switch voiding from uncontrolled CNS-pelvic parasympathetic action to voluntary CNSthoracolumbar sympathetic act, which leads to Injury of the IAS leads to fecal incontinence (FI).

References

SHOWING 1-10 OF 18 REFERENCES

Micturition and urinary continence

  • A. El HemalyL. Mousa
  • Medicine
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
  • 1996

Nocturnal enuresis: pathogenesis and treatment.

  • A. El Hemaly
  • Medicine
    International urogynecology journal and pelvic floor dysfunction
  • 1998
TLDR
It was concluded that giving ephedrine hydrochloride will improve internal sphincter tone, thus preventing uncontrolled urination.

Pelvic Floor Dysfunction, the Role of Imaging and Reconstructive Surgery

TLDR
The acquired factor, which is high alpha-sympathetic tone at the IUS gained from learning and training in early childhood, keeps it contracted and the urethra closes all the time until there is a need or a desire to void as social circumstances allow.

Ultrasonic Assessment of the Urethra and the Vagina in Normal Continent Womenand Women Suffering from Stress Urinary Incontinence and Vaginal Prolapse

Urinary continence depends on two factors: the presence of an intact and strong internal urethral sphincter (IUS); and on an acquiredbehavior, gained by learning and training in early childhood, how

A Novel Concept on the Patho-Physiology of Defecation and Fecal Incontinence (FI) in Women – Moreover, Its Reconstructive Surgery

TLDR
The aim is to explain the physiology of defection, factors that control fecal continence and causes of fecal incontinence in women together with the importance and the structure of the internal anal sphincter (IAS) and how it maintains fecalContinence.

The Concept and Pathophysiology of Urinary Incontinence

TLDR
The inherent factor is the presence of an intact and strong internal urethral sphincter, which is responsible for closure and opening of the urethra in response to alpha sympathetic tone.

Stress urinary incontinence, a new concept.

  • A. El HemalyL. Mousa
  • Medicine
    European journal of obstetrics, gynecology, and reproductive biology
  • 1996

Ultrasound Assessment of the Internal Anal Sphincter in Women with FecalIncontinence and Posterior Vaginal Wall Prolapse (Rectocele)

TLDR
A novel concept on the physiology of defecation is put forward, where the anal canal is closed and empty under normal circumstances and the collagen sheet of the IAS which causes its weakness is better demonstrated by imaging by 3D US.

Ultrasonic Assessment of the Internal Urethral Sphincter in Stress Urinary Incontinence

TLDR
Three dimensional U/S assessment of the internal unethral sphincter is very sensitive and specific for the diagnosis of SUI.

THE INTERNAL URETHRAL SPHINCTER AND THE VAGINA IN NORMAL WOMEN AND WOMEN SUFFERING FROM STRESS URINARY INCONTINENCE AND VAGINAL PROLAPSE

TLDR
Images show the IUS as a compact tissue cylinder that extends from the bladder neck to the urogenital diaphragm in continent women; IUS is torn in women with SUI.