మెడికల్ & సర్జికల్ యూరాలజీ
అందరికి ప్రవేశం

నైరూప్య

Voiding Troubles, Fecal Incontinence and Anal Intercourse

Abdel Karim M El Hemaly and Laila AS Mousa

Voiding (urine &/or feces) depends on:

Toilet training early in life switch voiding from uncontrolled CNS-pelvic parasympathetic action to voluntary CNSthoracolumbar sympathetic act.

The IAS is a collagen-muscle tissue cylinder that surround the anal canal. The IAS consists mainly of strong collagen tissue cylinder mixed with smooth plain muscle fibers with its nerve supply from the autonomic nervous system. It is surrounded in its lower part with the voluntary striated muscle, the external anal sphincter (EAS).

The IUS is a collagen-plain muscle tissue cylinder that extends from the bladder neck to the perineal membrane in both sex. The external urethral sphincter is a striated voluntary muscle lying in the deep perineal pouch. Voiding training induces and keeps high alpha-sympathetic tone at both the IUS & the IAS to maintain both contracted all the time, thus keeping the urethra & the anal canal empty and closed. On desire &/or need the person lowers the high alpha sympathetic tone at the IUS &/or the IAS to open the urethra &/ or the anal canal to void.

Injury of the IAS leads to fecal incontinence (FI). The injury is mostly traumatic from childbirth trauma (CBT) but it can be the result of anal intercourse. Subsequently the presence of excreta in the open anal canal will induce sense of desire to void; it may give false impression of desire to void urine (OAB).

Homosexuality &/or voiding incontinence are an important cause of psychological ailment.