title: Coexistence of elastic fibers with hyaluronic acid in the human urethral sphincter complex: a histological study.
abstract: OBJECTIVE
  To promote the prevention and treatment of urethral sphincteric dysfunction, we examined the distribution of elastic fibers around the urethral sphincter complex and the histological localization of hyaluronic acid in relation to elastic fiber architecture.
  
  
  METHODS
  Using elastica-Masson staining as well as biotinated hyaluronic acid binding protein, we examined specimens of the urethral sphincter complex obtained from 14 elderly Japanese cadavers, including 10 men and 4 women. As a control, we also observed other striated muscles in male cadavers.
  
  
  RESULTS
  Elastic fibers were densely distributed throughout the submucosal and smooth muscle layers along the entire length of the male urethra, including the prostatic urethra. The levator ani fascia and rhabdosphincter also contained abundant elastic fibers. An intramuscular elastic net was seen in the rhabdosphincter but not in other striated muscles. Strong staining for hyaluronic acid was evident in the submucosa and smooth muscle sphincter of the urethra but not in the levator ani fascia or rhabdosphincter, suggesting that elastic fibers and hyaluronic acid might interact at the former sites. Gender related differences in the distribution of elastic fibers and hyaluronic acid were noted with a much lower density of elastic fibers and hyaluronic acid staining in women than in men.
  
  
  CONCLUSIONS
  Urethral sites where elastic fibers and hyaluronic acid coexist could be targeted for the prevention and treatment of urethral sphincteric insufficiency. These findings should improve our understanding of the human urethral sphincter complex.
authors.affiliation: Department of Urology, Tottori University School of Medicine, Yonago, Japan; Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: hinata@med.tottori-u.ac.jp.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hinata
authors.forename: Gen
authors.initials: G
authors.lastname: Murakami
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Abe
authors.forename: Shunichi
authors.initials: S
authors.lastname: Shibata
authors.forename: Shuichi
authors.initials: S
authors.lastname: Morizane
authors.forename: Masashi
authors.initials: M
authors.lastname: Honda
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Isoyama
authors.forename: Takehiro
authors.initials: T
authors.lastname: Sejima
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takenaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D004547:Elastic Tissue / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000032:analysis; D008297:Male; D008875:Middle Aged; D014521:Urethra / Q000033:anatomy & histology* / Q000737:chemistry
chemical_list: D006820:Hyaluronic Acid
keywords: HA; elastic tissue; female; hyaluronic acid; male; urethra