Genitourinary Disorders: Lower Urinary Tract and Sexual Functions

Abstract

Experimental models in urology and sexual medicine have definitely helped to improve the clinical management of urogenitosexual dysfunctions. This chapter describes the most commonly used in vivo models for exploring urogenitosexual functions and for clarifying pathogenesis and evaluating potential treatments of urogenitosexual dysfunctions. Urogenitosexual functions include lower urinary tract and sexual functions. Lower urinary tract function can be evaluated by (i) monitoring changes in bladder pressure (cystometry), (ii) measuring urethral function (bladder outlet function), and (iii) recording of bladder somatosensory afferent (micturition trigger). Pathophysiological models of lower urinary tract dysfunctions comprise (i) bladder outlet obstruction that can be due to benign prostatic hyperplasia, (ii) overactive bladder leading to urinary incontinence that can be neurogenic or not (idiopathic), and (iii) painful bladder syndrome/interstitial cystitis corresponding to exaggerated sensation of pain or pressure in the bladder in the absence of evident infection. Sexual functions are explored using behavioral paradigms or measurement of peripheral responses. Sexual behavior has been divided into appetitive (sexual desire/motivation) and consummatory (copulation) aspects that can be evaluated using sexual preference paradigms and copulatory tests in both females and males. Peripheral sexual responses that can be assessed by recording physiological markers include (i) vaginal blood engorgement in females and (ii) penile erection and ejaculation in males. A few pathophysiological models have been proposed for female (related to menopause) and male (erectile dysfunction and premature ejaculation) sexual disorders. In the last section of this chapter, translational value of the experimental models in urology and sexual medicine is discussed with the help of examples.