The urethra (pl.: urethras or urethrae) is the tube that transports urine from the bladder to the urethral meatus of the penis or vulva in placental mammals. In males, it also transports semen through the penis during ejaculation. The external urethral sphincter is a striated muscle that allows voluntary control over urination. The internal urethral sphincter, formed by the involuntary smooth muscles lining the bladder neck and urethra, is innervated by the sympathetic division of the autonomic nervous system in males and females.
Structure The urethra is a fibrous and muscular tube which connects the urinary bladder to the external urethral meatus. Its length differs between the sexes, because it passes through the penis in males.
Male
The human male urethra is on average 18 to 20 centimeters (7 to 8 inches) long and opens at the end of the external urethral meatus. The urethra is divided into four parts in men, named after the location:
There is inadequate data for the typical length of the male urethra; however, a study of 109 men showed an average length of 22.3 cm (SD = 2.4 cm), ranging from 15 cm to 29 cm. The urethra in male placental mammals is typically longer than in females.
Female The human female urethra is about 4 cm long having 6 mm diameter,, extending from the internal urethral orifice of the bladder to the urethral meatus below the clitoris. The meatus is placed behind the symphysis pubis, embedded in the anterior wall of the vagina, and its direction is obliquely downward and forward; it is slightly curved with the concavity directed forward. The proximal two-thirds of the urethra is lined by transitional epithelial cells, while the distal third is lined by stratified squamous epithelial cells. Between the superior and inferior fascia of the urogenital diaphragm, the female urethra is surrounded by the urethral sphincter. The urethra in female placental mammals is typically shorter than in the male.
Microanatomy The cells lining the urethra (the epithelium) going all over transitional cells as it exits the bladder, which are variable layers of flat to cuboidal cells that change shape depending on whether they are compressed by the contents of the urethra. Further along the urethra there are pseudostratified columnar and stratified columnar epithelia. The lining becomes multiple layers of flat cells near the end of the urethra, which is the same as the external skin around it. There are small mucus-secreting urethral glands present in the urethral wall. In females, the paraurethral glands secrete mucous to lubricate the urethra; in males, the homologous bulbourethral glands. The urethra consists of three coats: muscular, erectile, and mucous, the muscular layer being a continuation of that of the bladder.
Blood and nerve supply and lymphatics Somatic (conscious) innervation of the external urethral sphincter is supplied by the pudendal nerve.
Development
In the developing embryo, at the hind end lies a cloaca. This, over the fourth to the seventh week, divides into a urogenital sinus and the beginnings of the anal canal, with a wall forming between these two inpouchings called the urorectal septum. The urogenital sinus divides into three parts, with the middle part forming the urethra; the upper part is largest and becomes the urinary bladder, and the lower part then changes depending on the biological sex of the embryo. The cells lining the urethra (the epithelium) come from endoderm, whereas the connective tissue and smooth muscle parts are derived from mesoderm. After the third month, urethra also contributes to the development of associated structures depending on the biological sex of the embryo. In the male, the epithelium multiples to form the prostate. In the female, the upper part of the urethra forms the urethra and paraurethral glands.
Function
Urination
The urethra is the vessel through which urine exits the bladder. During urination, the urethra's smooth muscle relaxes as the bladder contracts to expel urine in a pressurized stream. Following this, the urethra re-establishes muscle tone by contracting the smooth muscle layer, and the bladder returns to a relaxed, quiescent state. Urethral smooth muscle cells are mechanically coupled to each other to coordinate mechanical force and electrical signaling in an organized, unitary fashion.
Ejaculation The male urethra is the conduit for semen during orgasm. Urine is removed before ejaculation by pre-ejaculate fluid – called Cowper's fluid – from the bulbourethral gland.
Clinical significance
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