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Biol Sex Differ. 2018 Oct 22;9(1):45. doi: 10.1186/s13293-018-0204-8.

Sex differences in lower urinary tract biology and physiology.

Author information

1
Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
2
Department of Biophysics and Biophysical Chemistry, Johns Hopkins School of Medicine, Baltimore, MD, USA.
3
Society for Women's Health Research, Washington, DC, USA.
4
UConn Center on Aging, University of Connecticut, 263 Farmington, Farmington, CT, USA.
5
Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
6
Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Surgery, Duke University, Durham, NC, USA.
7
Department of Urology, Yale School of Medicine, New Haven, CT, USA.
8
Close Pediatric Urology, Henderson, NV, USA.
9
Department of Biomedical Sciences, Cooper Medical School of Rowan University, Camden, NJ, USA.
10
Department of Surgery, Division of Urology, Duke University Medical Center, Durham, NC, USA.
11
Department of Urology and Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
12
Department of Urology, Loyola University Chicago, Maywood, IL, USA.
13
Department of Obstetrics/Gynecology, Loyola University Chicago, Maywood, IL, USA.
14
School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
15
Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
16
Department of Urology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
17
Department of Microbiology and Immunology, Loyola University Chicago, Health Sciences Division, Stritch School of Medicine, Maywood, IL, 60153, USA.
18
Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA. damasem@ccf.org.
19
Department of Biomedical Engineering, Lerner Research Institute, The Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH, 44195, USA. damasem@ccf.org.
20
Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA. damasem@ccf.org.

Abstract

Females and males differ significantly in gross anatomy and physiology of the lower urinary tract, and these differences are commonly discussed in the medical and scientific literature. However, less attention is dedicated to investigating the varied development, function, and biology between females and males on a cellular level. Recognizing that cell biology is not uniform, especially in the lower urinary tract of females and males, is crucial for providing context and relevance for diverse fields of biomedical investigation. This review serves to characterize the current understanding of biological sex differences between female and male lower urinary tracts, while identifying areas for future research. First, the differences in overall cell populations are discussed in the detrusor smooth muscle, urothelium, and trigone. Second, the urethra is discussed, including anatomic discussions of the female and male urethra followed by discussions of cellular differences in the urothelial and muscular layers. The pelvic floor is then reviewed, followed by an examination of the sex differences in hormonal regulation, the urinary tract microbiome, and the reticuloendothelial system. Understanding the complex and dynamic development, anatomy, and physiology of the lower urinary tract should be contextualized by the sex differences described in this review.

KEYWORDS:

Cell biology; Lower urinary tract; Sex differences; Urology

PMID:
30343668
PMCID:
PMC6196569
DOI:
10.1186/s13293-018-0204-8
[Indexed for MEDLINE]
Free PMC Article

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