Urethral and bladder development during the 2nd gestational trimester applied to the urinary continence mechanism: trans
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ORIGINAL ARTICLE
Urethral and bladder development during the 2nd gestational trimester applied to the urinary continence mechanism: translational study in human female fetuses with neural tube defects Rodrigo R. Vieiralves 1 & Francisco J. B. Sampaio 1 & Luciano A. Favorito 1 Received: 24 July 2020 / Accepted: 1 September 2020 # The International Urogynecological Association 2020
Abstract Introduction and hypothesis We hypothesized that anencephaly impacts female lower urinary tract development during the human fetal period. The aim of the present study is to compare the biometric parameters of the bladder and urethra in female human fetuses with and without neural tube defects. Methods We studied 34 female fetuses (22 normal and 12 anencephalic), aged 12 to 22 weeks post-conception (WPC). After pelvic dissection and individualization of the urinary tract structures, we evaluated the bladder and urethra length and width using Image J software. Means were statistically compared using the Wilcoxon-Mann-Whitney test, and linear regression was performed. Results We identified statistical significance between the groups regarding bladder length [normal: 6.58–19.98 mm (mean = 12.13 ± 3.21 SD) vs. anencephalic: 4.59–15.27 mm (mean = 8.79 ± 3.31 SD, p = 0.0048] and urethral length [normal: 2.22– 7.04 mm (mean = 4.24 ± 1.45 SD) vs. anencephalic: 0.81–6.36 mm (mean = 3.25 ± 1.71 SD, p = 0.05]. We did not observe significant differences in bladder and urethra width between the two groups. The linear regression analysis indicated that the bladder length in anencephalic fetuses increased faster than in normal fetuses. Conclusions We observed significant differences in the development of the bladder and urethra in fetuses with anencephaly during the fetal period studied, proving that anencephaly can affect the development of the female fetal lower urinary tract. Keywords Urinary incontinence . Urethra . Bladder . Neural tube defects . Human fetuses
Introduction Urethral length is a very important factor in achieving continence during surgical treatment of some severe congenital malformations such as vesical exstrophy, cloacal exstrophy and omphalocele exstrophy imperforate anus spinal defects complex (OEIS) [1–3]. Fetal bladder sagittal length is an important parameter for estimating the development of fetal bladder size to predict the existence of bladder dilation or megacystis during prenatal evaluation [4]. Neural tube defects are one of the most common congenital malformations of the central nervous system, with
* Luciano A. Favorito [email protected] 1
Urogenital Research Unit, State University of Rio de Janeiro, Rua Professor Gabizo, 104/201, Rio de Janeiro, Tijuca CEP: 20271-320, Brazil
anencephaly being the most severe form, resulting from failure of the neural tube to close at the base of the skull [5, 6]. Little is known about the development of organs in anencephalic fetuses, although some advances in this direction have been achieved in recent years from studies of organs of the urinary tract. The morphol
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