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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

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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.

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References

  1. Halleran DR, Thompson B, Fuchs M, Vilanova-Sanchez A, Rentea RM, Bates DG, et al. Urethral length in female infants and its relevance in the repair of cloaca. J Pediatr Surg. 2019;54:303–6.

    Article  Google Scholar 

  2. Mathews R. Achieving urinary continence in cloacal exstrophy. Semin Pediatr Surg. 2011;20:126–9.

    Article  Google Scholar 

  3. Phillips TM, Salmasi AH, Stec A, Novak TE, Gearhart JP, Mathews RI. Urological outcomes in the omphalocele exstrophy imperforate anus spinal defects (OEIS) complex: experience with 80 patients. J Pediatr Urol. 2013;9:353–8.

    Article  Google Scholar 

  4. Maizels M, Alpert SA, Houston JTB, Sabbagha RE, Parilla BV, MacGregor SN. Fetal bladder sagittal length: a simple monitor to assess normal and enlarged fetal bladder size, and forecast clinical outcome. J Urol. 2004;172:1995–9.

    Article  Google Scholar 

  5. Blatter BM, van der Star M, Roeleveld N. Review of neural tube defects: risk factors in parental occupation and the environment. Environ Health Perspect. 1994;102:140–5.

    Article  CAS  Google Scholar 

  6. Cook RJ, Erdman JN, Hevia M, Dickens BM. Prenatal management of anencephaly. Int J Gynecol Obstet. 2008;102:304–8.

    Article  Google Scholar 

  7. Cunha GR, Robboy SJ, Kurita T, Isaacson D, Shen J, Cao M, et al. Development of the human female reproductive tract. Differentiation. 2018;103:46–65.

    Article  CAS  Google Scholar 

  8. Hern W. Correlation of fetal age and measurements between 10 and 26 weeks of gestation. Obstet Gynecol. 1984;63:26–32.

    CAS  PubMed  Google Scholar 

  9. Mercer BM, Sklar S, Shariatmadar A, Gillieson MS, D’Alton ME. Fetal foot length as a predictor of gestational age. Am J Obstet Gynecol. 1987;156:350–5.

    Article  CAS  Google Scholar 

  10. Platt L, Medearis A, DeVore G, Horenstein J, Carlson D, Brar H. Fetal foot length: relationship to menstrual age and fetal measurements in the second trimester. Obstet Gynecol. 1988;71:526–31.

    CAS  PubMed  Google Scholar 

  11. Bidra AS, Uribe F, Thomas S, Agar JR, Rungruanganunt P, Neace WP. The relationship of facial anatomic landmarks with midlines of the face and mouth. J Prosthet Dent. 2009;102:94–103.

    Article  Google Scholar 

  12. Tello C, Liebmann J, Potash SD, Cohen H, Hitsch R. Measurement of ultrasound biomicroscopy images: Intraobserver and Interobserver reliability. Investigaiive Ophthalmol Vis Sci. 1994;35:349–3552.

    Google Scholar 

  13. Vieiralves RR, Ribeiro GS Jr, Alves EF, Sampaio FJ, Favorito LA. Are anogenital distance and external female genitalia development changed in neural tube defects? Study in human fetuses. J Pediatr Urol. 2020;18:S1477-5131(20):30426–5. https://doi.org/10.1016/j.jpurol.2020.07.015 Online ahead of print.

    Article  Google Scholar 

  14. Fritsch H, Pinggera GM, Lienemann A, Mitterberger M, Bartsch G, Strasser H. What are the supportive structures of the female urethra? Neurourol Urodyn. 2006;25:128–34.

    Article  Google Scholar 

  15. Husmann DA, Vandersteen DR, Mclorie GA, Churchill BM. Urinary continence after staged bladder reconstruction for cloacal exstrophy: the effect of coexisting neurological abnormalities on urinary continence. J Urol. 1999;161:1598–602.

    Article  CAS  Google Scholar 

  16. Matsumaru D, Haraguchi R, Moon AM, Satoh Y, Nakagata N, Yamamura KI, et al. Genetic analysis of the role of Alx4 in the coordination of lower body and external genitalia formation. Eur J Hum Genet. 2014;22:350–7.

    Article  CAS  Google Scholar 

  17. Gevers S. Third trimester abortion for fetal abnormality. Bioethics. 1999;13:306–13.

    Article  Google Scholar 

  18. Carvalho JPM, Costa WS, Sampaio FJB, Favorito LA. Anencephaly does not cause structural alterations in the fetal penis. J Sex Med. 2012;9:735–42.

    Article  Google Scholar 

  19. Pires RS, Gallo CM, Sampaio FJ, Favorito LA. Do prune-belly syndrome and neural tube defects change testicular growth? A study on human fetuses. J Pediatr Urol. 2019;15:557–61.

    Article  Google Scholar 

  20. Pazos HMF, Lobo ML de P, Costa WS, Sampaio FJB, Cardoso LEM, Favorito LA. Do neural tube defects lead to structural alterations in the human bladder? Histol Histopathol. 2011;26:581–8.

    PubMed  Google Scholar 

  21. Brumfield CG, Guinn D, Davis R, Owen J, Wenstrom K, Mize P. The significance of non-visualization of the fetal bladder during an ultrasound examination to evaluate second-trimester oligohydramnios. Ultrasound Obstet Gynecol. 1996;8:186–91.

    Article  CAS  Google Scholar 

  22. Vinit N, Grevent D, Millischer-Bellaiche A, Pandya VM, Sonigo P, Delmonte A, et al. Biometric and morphological features of the fetal bladder in lower urinary tract obstruction on magnetic resonance imaging: new perspectives for fetal cystoscopy. Ultrasound Obstet Gynecol. 2019;56:86–95.

    Article  Google Scholar 

  23. Favorito LA, Costa WS, Lobo M luis P, Gallo CM, Sampaio FJ. Morphology of the fetal renal pelvis during the second trimester: comparing genders. J Pediatr Surg. 2020;19:1014–9.

    Google Scholar 

  24. Masumoto H, Rodríguez-Vázquez JF, Verdugo-López S, Murakami G, Matsubara A. Fetal topographical anatomy of the female urethra and descending vagina: a histological study of the early human fetal urethra. Ann Anat. 2011;193:500–8.

    Article  Google Scholar 

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Funding

This work was supported by the National Council for Scientific and Technological Development (CNPq-Brazil) and the Rio de Janeiro State Research Foundation (FAPERJ).

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Authors and Affiliations

  1. Urogenital Research Unit, State University of Rio de Janeiro, Rua Professor Gabizo, 104/201, Rio de Janeiro, Tijuca, CEP: 20271-320, Brazil

    Rodrigo R. Vieiralves, Francisco J. B. Sampaio & Luciano A. Favorito

Authors
  1. Rodrigo R. Vieiralves
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  2. Francisco J. B. Sampaio
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  3. Luciano A. Favorito
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Contributions

RR Vieiralves: Project development, Data Collection, Manuscript writing.

Sampaio FJ: Manuscript writing.

Favorito La: Project development, Data Collection, Manuscript writing.

Corresponding author

Correspondence to Luciano A. Favorito.

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Vieiralves, R.R., Sampaio, F.J.B. & Favorito, L.A. 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. Int Urogynecol J 32, 647–652 (2021). https://doi.org/10.1007/s00192-020-04528-6

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  • DOI: https://doi.org/10.1007/s00192-020-04528-6

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