Mills I W, Noble J G, Brading A F
Oxford Continence Group, University Department of Pharmacology and Department of Urology, Churchill Hospital, Headington, Oxford, United Kingdom.
J Urol. 2000 Nov;164(5):1745-50.
Cystometry has previously been performed in awake animals using vesical and abdominal catheters, and artificial bladder filling. Conventional urodynamic recordings may be obtained in this manner, albeit under nonphysiological and potentially stressful conditions. Therefore, we developed a technique to perform continuous, ambulatory cystometric monitoring in pigs.
A dual pressure radiotelemetry device was surgically implanted in 22 large white pigs. Vesical and abdominal pressures were recorded and validated, subtracted detrusor pressures were derived and natural fill and diuresis cystometry was compared.
Continuous recordings were obtained for 1 to 24 hours, and the devices remained in the animals for up to 3 months. There were few complications and incrustation of the intravesical catheter tip occurred but it did not appear to affect recorded pressures. The pressure data were validated by comparison with filling pressures during bladder distention and simultaneous conventional cystometry at the end of the experimental period. Comparison of natural filling and diuresis cystometrograms showed that natural bladder filling results in higher maximum detrusor pressure during voiding (38.1 versus 33.9 cm. H2O, p <0.05), higher detrusor pressure after contractions (42.6 versus 32.2 cm. H2O, p <0.05) and more frequent detection of unstable contractions in pigs with detrusor instability secondary to experimental manipulation of the lower urinary tract (77.8% versus 45.0%, p <0.05).
This technique allows continuous cystometric monitoring in less stressed animals under more physiological conditions for relatively long periods and, thus, allows prolonged assessment of bladder function in pigs in response to pathological and pharmacological manipulations. Nonphysiological rates of bladder filling have been shown to result in detrusor inhibition, which emphasizes the importance of ambulatory cystometry when describing bladder function.
以往在清醒动物中进行膀胱测压时,需使用膀胱和腹部导管,并进行人工膀胱充盈。尽管是在非生理且可能有压力的条件下,但以此方式可获得传统的尿动力学记录。因此,我们开发了一种在猪身上进行连续动态膀胱测压监测的技术。
将双压力无线电遥测装置手术植入22头大白猪体内。记录并验证膀胱和腹部压力,得出减去的逼尿肌压力,并比较自然充盈和利尿膀胱测压。
连续记录1至24小时,装置在动物体内保留长达3个月。并发症很少,膀胱内导管尖端出现结痂,但似乎未影响记录的压力。在实验期结束时,通过与膀胱扩张时的充盈压力及同时进行的传统膀胱测压相比较,对压力数据进行了验证。自然充盈和利尿膀胱测压图的比较显示,自然膀胱充盈导致排尿时最大逼尿肌压力更高(38.1对33.9厘米水柱,p<0.05),收缩后逼尿肌压力更高(42.6对32.2厘米水柱,p<0.05),并且在因下尿路实验操作继发逼尿肌不稳定的猪中,更频繁地检测到不稳定收缩(77.8%对45.0%,p<0.05)。
该技术可在压力较小的动物处于更生理的条件下进行相对长时间的连续膀胱测压监测,从而能够长期评估猪膀胱功能对病理和药理操作的反应。已表明非生理的膀胱充盈速率会导致逼尿肌抑制,这强调了动态膀胱测压在描述膀胱功能时的重要性。