PD20-03 FEMALE PERIURETHRAL TISSUE INNERVATION STUDIES: MID-URETHRAL SLING SURGERIES MAY RESULT IN SEXUAL DYSFUNCTION
Bibliographic record
Abstract
You have accessJournal of UrologySexual Function/Dysfunction: Female (PD20)1 Apr 2019PD20-03 FEMALE PERIURETHRAL TISSUE INNERVATION STUDIES: MID-URETHRAL SLING SURGERIES MAY RESULT IN SEXUAL DYSFUNCTION Olivia Giovannetti, Madeline Monaghan, Johanna Hannan*, Barry Komisaruk, Sue Goldstein, Irwin Goldstein, and Michael Adams Olivia GiovannettiOlivia Giovannetti More articles by this author , Madeline MonaghanMadeline Monaghan More articles by this author , Johanna Hannan*Johanna Hannan* More articles by this author , Barry KomisarukBarry Komisaruk More articles by this author , Sue GoldsteinSue Goldstein More articles by this author , Irwin GoldsteinIrwin Goldstein More articles by this author , and Michael AdamsMichael Adams More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555735.67736.aaAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: The female periurethral tissue (FPT) contains numerous glands staining positive for prostate specific acid. These glands are surrounded by neuronal and vascular structures, and may have physiologic contribution to sexual function. The PFT is located adjacent to the anterior vaginal wall epithelium and surrounds the urethra passing distally from the bladder neck to the meatus. Decreased sexual function, especially lowered orgasm satisfaction has been reported following mid-urethral sling procedures to treat stress urinary incontinence, and requires further investigation of this possible iatrogenic effect. Cadaver studies have shown the mid-urethral sling transects through the glandular, neuronal, and vascular structures of the PFT. The goal of this new research is to further histologically characterize the PFT and examine patterns of innervation in relation to its specific morphological features. METHODS: Histologic and immunohistochemical investigations of glandular, vascular, and nervous structures of the FPT were examined from three fresh human female cadavers. The region of PFT examined was located in the same location of implanted mid-urethral slings. RESULTS: Positive staining for Anti-Nav 1.8 (sodium channel NaV 1.8), Anti-TH (tyrosine hydroxylase), and Anti-ChAT (choline acetyl transferase) indicated the presence of sensory, sympathetic, and parasympathetic innervation, respectively. The patterns of innervation of glandular and vascular structures varied depending on the type of innervation received. Nerve fibers were also located and stained positively for these three specific stains. Not all nerve subpopulations that stained positively for PGP9.5 were identified with the specific immunohistochemistry used in this investigation, and further immunohistochemistry is needed to stain for possible non-adrenergic non-cholinergic innervation. The qualitative analysis of serial tissue sections demonstrated multiple types of innervation of blood vessels and glandular tissue, and the existence of nerve fibers. CONCLUSIONS: The glandular, vascular, and neuronal structures of the FPT have multiple types of innervation consistent with a physiologic functioning organ, likely involved in female sexual response. Future studies will aim to: 1) further classify the subpopulations of nerves to correlate nerve type with female sexual responses, and 2) assess surgical modifications of mid-urethral sling placements to reduce risk of post-surgical sexual dysfunction. Source of Funding: None Kingston, Canada; Greenville, NC; Newark, NJ; San Diego, CA; Kingston, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e377-e378 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Olivia Giovannetti More articles by this author Madeline Monaghan More articles by this author Johanna Hannan* More articles by this author Barry Komisaruk More articles by this author Sue Goldstein More articles by this author Irwin Goldstein More articles by this author Michael Adams More articles by this author Expand All Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.345 | 0.074 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".