排尿困难,大便失禁和肛交

A. E. Hemaly, L. Mousa
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摘要

排尿(尿和/或粪便)取决于:生命早期的如厕训练将排尿从不受控制的中枢-骨盆副交感神经动作转换为自主的中枢-腰腰椎交感神经动作。IAS是一个围绕肛管的胶原-肌肉组织圆柱体。IAS主要由强胶原组织柱与平滑肌纤维混合组成,其神经供应来自自主神经系统。它的下部被随意横纹肌,即肛门外括约肌(EAS)所包围。IUS是一个胶原蛋白平滑肌组织圆柱体,从膀胱颈部延伸至会阴膜。尿道外括约肌是位于会阴深囊内的横纹肌。排尿训练诱导并保持IUS和IAS的高α交感神经张力,使两者始终保持收缩,从而保持尿道和肛管的空闭。出于欲望和/或需要,患者降低IUS和/或IAS处的高α交感神经张力,以打开尿道和/或肛管进行排空。IAS损伤可导致大便失禁(FI)。这种损伤主要来自分娩创伤(CBT),但也可能是肛交的结果。随后,在开放肛管中出现的排泄物会引起渴望排空的感觉;它可能给人一种想要排尿(OAB)的错觉。同性恋和/或尿失禁是心理疾病的重要原因。
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Voiding Troubles, Fecal Incontinence and Anal Intercourse
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.
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