Morphology and Function.
A M ulti-Disci plinary, M ulti-l nstitutional Approach Morphology and function. How are they related? For those of us who ponder the mechanism of continence, it is obvious that there is no urethral sphincter. At least there is none that we can see with the naked eye. The microscope seems little help in this regard, but we all know where the sphincter resides. It is in the proximal portion of the urethra in both sexes. How do we know if we cannot see it? We know because we can see and measure various parameters of sphincteric function. By viewing the radiographic appearance of the full bladder we can be sure that continence is normally maintained at the level of the vesical neck; by measuring the pressure in the urethra our visual observations are confirmed.
Morphology and function. The prostatic urethras of most 70 year old men look "obstructed" when one peers through the cystoscope, yet some can void and some cannot. Some are symptomatic and some are not. We must "look more deeply" to understand the truth, first using the cystoscope, then the microscope, then the electron microscope. That is how we look. But what about function? We can infer function by looking even more deeply, by using special stains for identifying nerves and neurotransmitters whose function we think we understand, or we can assess function directly. We can measure detrusor pressure and uroflow, and from these values we can calculate detrusor power and work. We are hopeful that this approach will culminate in indices of detrusor contractility that will clearly differentiate bladder outlet obstruction from impairment of detrusor contractility. We hope to be able to determine the morphologic and functional effects of urethral obstruction.
Morphology and function. What are the effects of urethral obstruction on the bladder? We most look more deeply. This issue of the journal is the culmination of a unique collaboration amongst world-reknowned experts in anatomy, biochemistry, biomedical engineering, pathology, physiology and urology. This multi-disciplinary, multi-institutional series of experiments has done much to expand our knowledge of this intriguing field of urology and should serve as a model for future research collaboration. The investigators are to be congratulated not only for the results of their research but for their innovative, cooperative, multidisciplinary approach to pursuing high quality research.