RESUMO
The male urogenital system is composed of the reproductive system and the urinary tract; they have an interconnected embryonic development and share one of their anatomical components, the urethra. This system has a highly complex physiology deeply interconnected with the circulatory and nervous systems, as well as being capable of adapting to environmental variations; it also undergoes changes with aging and, in the case of the reproductive system, with seasonality. The stroma is an essential component in this physiological plasticity and its complexity has increased with the description in the last decade of a new cell type, the telocyte. Several studies have demonstrated the presence of telocytes in the organs of the male urogenital system and other systems; however, their exact function is not yet known. The present review addresses current knowledge about telocytes in the urogenital system in terms of their locations, interrelationships, possible functions and pathological implications. It has been found that telocytes in the urogenital system possibly have a leading role in stromal tissue organization/maintenance, in addition to participation in stem cell niches and an association with the immune system, as well as specific functions in the urogenital system, lipid synthesis in the testes, erythropoiesis in the kidneys and the micturition reflex in the bladder. There is also evidence that telocytes are involved in pathologies in the kidneys, urethra, bladder, prostate, and testes.
Assuntos
Telócitos/patologia , Telócitos/fisiologia , Sistema Urogenital/patologia , Sistema Urogenital/fisiologia , Animais , Doenças dos Genitais Masculinos/patologia , Doenças dos Genitais Masculinos/fisiopatologia , Humanos , Metabolismo dos Lipídeos/fisiologia , Masculino , Próstata/citologia , Próstata/patologia , Próstata/fisiologia , Células-Tronco/patologia , Células-Tronco/fisiologia , Testículo/citologia , Testículo/patologia , Testículo/fisiologia , Bexiga Urinária/citologia , Bexiga Urinária/patologia , Bexiga Urinária/fisiologia , Sistema Urogenital/citologiaRESUMO
Resumen El sistema genitourinario presenta una serie de cambios micro y macroanatómicos desde el nacimiento, pasando por la pubertad, período reproductivo y por último con la menopausia, en la cual, se desarrolla un conjunto de síntomas sistémicos que incluyen los vasomotores, del sueño, cognitivos, del estado de ánimo y cambios sexuales, asociados a la presencia de disminución de la lubricación, estrechamiento y distensibilidad vaginal, atrofia vaginal, entre otros, que llevan a presentar una clínica de dispareunia, prurito, resequedad, además de síntomas urinarios. Su examinación conlleva la realización de una historia clínica, examen físico y ginecológico. Para confirmar los cambios se puede hacer una medición de pH y una citología para determinar un índice de maduración vaginal. Cuando estos síntomas se asocian a angustia y molestia se puede estar ante un caso de disfunción sexual, del cual se conocen factores de riesgo para su presencia como la edad como tal, problemas de pareja, estado de salud, autoestima, entre otros. Es por esto que a razón del tratamiento es importante hacer un abordaje interdisciplinario.
Abstract The genitourinary system presents a series of micro and macroanatomical changes from birth, through puberty, reproductive period and finally with menopause, in which a set of systemic symptoms are developed, including vasomotor, sleep, cognitive, mood and sexual changes, associated with the presence of decreased lubrication, narrowing and vaginal distensibility, vaginal atrophy, among others, leading to clinical symptoms of dyspareunia, pruritus, dryness, and urinary symptoms. Its examination involves the realization of a clinical history, physical and gynecological examination. To confirm the changes, a pH measurement can be made and a cytology to determine a vaginal maturation index. When these symptoms are associated with anguish and discomfort, there may be a case of sexual dysfunction, of which there are known risk factors for their presence such as age as such, couple problems, health status, self-esteem, among others. That is why, as to treatment, it is important to make an interdisciplinary approach.
Assuntos
Humanos , Feminino , Disfunções Sexuais Fisiológicas , Sistema Urogenital/fisiologia , Envelhecimento , MenopausaRESUMO
OBJECTIVE: To determine the association between sexual function and depression in sexually active, mid-aged women while controlling for sociodemographical and clinical factors. METHODS: Data were analyzed from 335 healthy, sexually active, Peruvian women (40-59 years) who simultaneously filled out the Female Sexual Function Index (FSFI), the Menopause Rating Scale (MRS), the Beck Depression Inventory (BDI) and a general questionnaire containing female/partner data. Correlations between the measures of all tools were analyzed. RESULTS: The median age of studied women was 49 years; 76.7% had low schooling, 40% were postmenopausal and 15.2% used hormone therapy. Regarding the partner, 11% and 10.5% presented erectile dysfunction and premature ejaculation, respectively. FSFI total scores displayed significant correlations with BDI and MRS scores (total, psychological and urogenital). Multiple linear regression analysis was used to obtain an association model between sexual function and depression, explaining 88% of the variance. In this model, sexual function was inversely associated with depression, yet confounded by MRS urogenital scores. In addition, sexual function was inversely correlated to partner sexual function and to female MRS psychological scorings and positively to premenopausal status. CONCLUSION: In this mid-aged series, sexual function was significantly associated with depression, in addition to hormonal status and partner sexual function.
Assuntos
Depressão/epidemiologia , Menopausa , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Adulto , Idoso , Estudos Transversais , Depressão/fisiopatologia , Depressão/psicologia , Escolaridade , Disfunção Erétil/epidemiologia , Disfunção Erétil/fisiopatologia , Disfunção Erétil/psicologia , Feminino , Terapia de Reposição Hormonal/estatística & dados numéricos , Humanos , Modelos Lineares , Masculino , Menopausa/fisiologia , Menopausa/psicologia , Pessoa de Meia-Idade , Peru/epidemiologia , Disfunções Sexuais Fisiológicas/fisiopatologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Psicogênicas/fisiopatologia , Disfunções Sexuais Psicogênicas/psicologia , Parceiros Sexuais , Estatísticas não Paramétricas , Inquéritos e Questionários , Sistema Urogenital/fisiologiaRESUMO
El texto que sigue muestra el enfrentamiento que tradicionalmente un anestesiólogo hace durante la evaluación preoperatoria de un paciente sea éste de urgencia o electivo. Esto consiste en interiorizarse de la historia, obteniendo la mayor cantidad de información de la condición médica actual y pasada del paciente, un examen físico dirigido, efectuar un análisis sistémico del paciente, solicitar y leer los exámenes pertinentes y dejar las indicaciones apropiadas. Toda la información anterior permitirá clasificar al enfermo de acuerdo a su condición física, evaluar su riesgo y planificar la conducta periopertoria.
These document lineament is given by the traditionally way for an anesthetist to perform the preoperative evaluation of a pacient even if he is an urgency or an elective pacient. This consists in reviewing the history, getting the most information about the present and past medical condition of the pacient, running a guided fisical exam, a sistemic analisis of the pacient, after wich the pertinent exams should be asked and read, then the appropiate indications should de made. All of the previous information will allow a clasification of the pacient acording to his physical condition, evaluate his risk and planning the perioperative.
Assuntos
Anestesia/normas , Fenômenos Fisiológicos Cardiovasculares , Cuidados Pré-Operatórios/métodos , Cuidados Pré-Operatórios/normas , Fenômenos Fisiológicos Respiratórios , Sistema Urogenital/fisiologia , Fatores de RiscoRESUMO
Melatonin is secreted by the pineal gland and this is linked to the day/night cycle. It is an antioxidant and plays a fundamental role in the regulation of the jet-lag stage, in several physiological reactions and in control of the biologic rhythm. Human melatonin has an important influence on the female genital system. In fact, melatonin may influence production and action of steroids, modifying cellular signalization on the target tissue. There are many evidences that the melatonin therapy may be interfering with neoplasia development, mainly of the estrogen-dependent tumor. This paper aims to analyze the actions of melatonin on the neuroendocrine, immunological and cardiovascular systems, as well as on the reproductive function.
Assuntos
Melatonina/fisiologia , Sistema Urogenital/fisiologia , Ritmo Circadiano , Estrogênios/fisiologia , Feminino , Humanos , Melatonina/metabolismo , Neoplasias/fisiopatologia , Ovário/fisiologia , Glândula Pineal/fisiologia , Sono/fisiologia , Útero/fisiologiaRESUMO
A melatonina é um hormônio produzido pela glândula pineal, cuja secreção está diretamente relacionada ao ciclo claro-escuro. É um poderoso antioxidante e tem papel fundamental na regulação do estado sono/vigília, do ritmo de vários processos fisiológicos, participando do controle do relógio biológico, inclusive nos seres humanos. Ressalta-se que há evidências da sua ação no sistema genital feminino, influenciando a função ovariana e a fertilidade. De fato, este hormônio interage com esteróides sexuais, como o estrogênio, modificando a sinalização celular e a resposta no tecido alvo. Estudos clínicos sugerem que o tratamento com a melatonina interviria com a evolução de neoplasia-dependente do estrogênio. O objetivo dessa revisão é analisar as principais ações da melatonina no sistema neuroendócrino, no ciclo sono-vigília, no sistema imunológico, no sistema cardiovascular, bem como no sistema reprodutor.
Melatonin is secreted by the pineal gland and this is linked to the day/night cycle. It is an antioxidant and plays a fundamental role in the regulation of the jet-lag stage, in several physiological reactions and in control of the biologic rhythm. Human melatonin has an important influence on the female genital system. In fact, melatonin may influence production and action of steroids, modifying cellular signalization on the target tissue. There are many evidences that the melatonin therapy may be interfering with neoplasia development, mainly of the estrogen-dependent tumor. This paper aims to analyze the actions of melatonin on the neuroendocrine, immunological and cardiovascular systems, as well as on the reproductive function.
Assuntos
Feminino , Humanos , Melatonina/fisiologia , Sistema Urogenital/fisiologia , Ritmo Circadiano , Estrogênios/fisiologia , Melatonina/metabolismo , Neoplasias/fisiopatologia , Ovário/fisiologia , Glândula Pineal/fisiologia , Sono/fisiologia , Útero/fisiologiaRESUMO
It is well conceived that the intention of man in trying to solve human kind ailments, is being a long standing biological rule to give rational solutions at any rate. The response to the current problem studied, approaches a different view of the peripheral and local deteriorating phenomena and offers--in a non classical way--how to maintain the well-being of a population of otherwise healthy women, in trying to defer the degenerative cellular process. Interesting, as the proximity of the XXI century arrives, the technology and the biomedical level of progress seems to be for a way from the ideal, particularly when dealing with a process initiated years before the menopause. This critical period of hormonal imbalance makes also a definite++ e social change for women; such a combination of facts, prompt us to be aware that in society, a women is no longer biologically reproductive but certainly, productive, as an economical drive digure. Needless to say that we must be protective to her and to realize that the number of them will continue to an increase in the years to come. The following two comments intended to associate various levels of the current knowledge of one of the Public Health problems in women.
Assuntos
Morte Celular , Sistema Urogenital/metabolismo , Glândulas Suprarrenais/fisiologia , Adulto , Idoso , Feminino , Humanos , Sistema Hipotálamo-Hipofisário/fisiologia , Metabolismo dos Lipídeos , Masculino , Pessoa de Meia-Idade , Ovário/fisiologia , Progesterona/metabolismo , Sistema Urogenital/fisiologiaRESUMO
BACKGROUND: The aim of the study was to investigate how neonatal undernutrition interacts with mother-infant relationships to interfere with the expression of the urogenital response in the newborn. METHODS: The hyperextensive reflex components associated to the urogenital response (HUR) were measured between postnatal days 1-21, in control and neonatally undernourished rats with or without fullness of the bladder. RESULTS: In Experiment 1, both male and female underfed rats with different degrees of bladder fullness exhibited an increment in HUR latency and vertical hindlimb displacement, reduced transversal separation and prolonged performance of hindlimb relaxation. Experiment 2 was performed in rats after urine elicitation provoked only reduced hindlimb transversal separation in males, and prolonged latency to HUR in females. DISCUSSION: These findings may be related to the vulnerability to neonatal undernutrition of the maturational processes which take place in the spinal cord, the condition of the bladder, and hindleg muscle maturation during this period of life. CONCLUSIONS: Data suggest that neonatal undernutrition may play a role in mother-infant interaction by interfering with HUR responses to maternal anogenital licking of the pups.
Assuntos
Distúrbios Nutricionais/complicações , Reflexo/fisiologia , Sistema Urogenital/fisiologia , Animais , Animais Recém-Nascidos , Feminino , Membro Posterior , Masculino , Amplitude de Movimento Articular , Ratos , Ratos WistarRESUMO
Background. The aim of the study was to investigate how neonatal undernutrition interacts with mother-infant relationship to interfere with the expression of the urogenital response in the newborn. Methods. The hyperextensive reflex components associated to the urogenital response (HUR) were measured between postnatal days 1-21, in control and neonatally undernourished rats with or without fullness of the bladder. Results. In Experiment 1, both male and female underfed rats with different degress of bladder fullness exhibited an increment in HUR latency and vertical hindlimb displacement, reduced transversal separation and prolonged performance of hindlimb relaxation. Experiment 2 was performed in rats after urine elicitation provoked only reduced hindlimb transversal separation in males, and prolonged latency to HUR in females. Discussion. These findings may be related to the vulneability to neonatal undernutrition of the maturational processes which take place in the spinal cord, the condition of the bladder, and hinleg muscle maturation during this period of life. Conclusions. Data suggest that neonatal undernutrition may play a role in mother-infant interaction by interfering with HUR responses to maternal anogenital licking of pups
Assuntos
Animais , Masculino , Feminino , Ratos , Animais Recém-Nascidos , Extremidades , Membro Posterior , Amplitude de Movimento Articular , Ratos Wistar , Reflexo/fisiologia , Sistema Urogenital/fisiologiaRESUMO
O estudo objetiva investigar a prevalência de distúrbios urinários e genitais em mulheres climatéricas. Entrevistaram-se 229 mulheres que foram submetids ao exame ginecológico no Ambulatório de Climatério do Centro de Atençäo Integral à Mulher da Universidade Estadual de Campinas, através de questionário detalhado, observando-se variáveis como idade, raça, estado marital, antecedentes tocoginecológicos, uso de anticoncepçäo hormonal, estado mesntrual, uso de terapia de reposiçäo hormonal, cirurgia prévia de incontinência urinária de repetiçäo, diabetes, tabagismo, tosse crônica, quimioterapia eou radioterapia prévia, distopias genitais, trofismo vaginal, muco cervical e teste de Schiller. A freqüência dos distúrbios urinários foi de 42, 8 por cento, sendo o sintoma mais encontrado a incontinência urinária pouco mais da metade das mulheres (54,1 por cento) apresentavam queixas genitais, sendo a secura vaginal a mais freqüente, seguida pela dispaurenia e prurido. Os fatores que se associaram à prevalência de queixas urinárias foram o número de gestaçöes, números de partos e presença de distopias genitais. Já a presença de parceiro, antecedente de diabetes, cirurgia anterior para incontinência urinária, infecçäo urinária de repetiçäo, menor trofismo gential e menor índice de massa corpórea associaram-se à prevalência genitais. Conclui-se que os fatores associados à prevalência de queixas urinárias e genitais säo distintos e que merecem, portanto, uma abordagem diferente dos pontos de vista propedêutico e terapêutico