Damaser Margot S, Broxton-King Carla, Ferguson Corri, Kim Fernando J, Kerns James M
Research Service (151), Hines Veterans Affairs Hospital, 5th Avenue and Roosevelt Road, Hines, IL 60141, USA.
J Urol. 2003 Sep;170(3):1027-31. doi: 10.1097/01.ju.0000079492.09716.43.
We tested the hypothesis that neuroanatomical degeneration near the external urethral sphincter (EUS) would parallel urinary dysfunction after vaginal distention or bilateral pudendal nerve crush in female rats.
A total of 28 female rats underwent bilateral pudendal nerve crush or vaginal distention, or were unoperated controls. Two days later a catheter was implanted into the bladder dome and 2 days after that (4 days after injury) urethral leak point pressure testing was performed with the rat under urethane anesthesia. The pudendal nerve and urethra were then dissected and prepared for light and electron microscopy.
Leak point pressure was significantly decreased 4 days after pudendal nerve crush and vaginal distention (29.3 +/- 3.4 and 31.0 +/- 2.5 cm H(2)O, respectively) compared with controls (44.3 +/- 3.4 cm H(2)O). The percentage of nerve fascicles with degeneration near the EUS was significantly greater in the nerve crush (13.1% +/- 1.7%) and vaginal distention (7.2% +/- 2.2%) groups than in the control group (0% +/- 0%). There were fewer nerve fascicles near the EUS in the ventral half of the urethral cross section than in the dorsal half in all 3 groups and the percent of fascicles with degeneration was greater in the ventral half than in the dorsal half in the 2 injury groups.
These results suggest that the pudendal nerve is particularly vulnerable to injury during vaginal distention in this animal model. The 2 injury models may be useful for investigating the pathophysiology of stress urinary incontinence.
我们验证了这样一个假设,即雌性大鼠阴道扩张或双侧阴部神经挤压后,尿道外括约肌(EUS)附近的神经解剖学退变与排尿功能障碍平行。
总共28只雌性大鼠接受双侧阴部神经挤压或阴道扩张,或作为未手术的对照。两天后,将导管植入膀胱顶部,在此之后两天(损伤后4天),在大鼠处于氨基甲酸乙酯麻醉状态下进行尿道漏点压力测试。然后解剖阴部神经和尿道,准备用于光镜和电镜检查。
与对照组(44.3±3.4 cm H₂O)相比,阴部神经挤压和阴道扩张后4天漏点压力显著降低(分别为29.3±3.4和31.0±2.5 cm H₂O)。EUS附近出现退变的神经束百分比在神经挤压组(13.1%±1.7%)和阴道扩张组(7.2%±2.2%)显著高于对照组(0%±0%)。在所有3组中,尿道横截面腹侧半部EUS附近的神经束少于背侧半部,并且在2个损伤组中,腹侧半部退变神经束的百分比高于背侧半部。
这些结果表明,在该动物模型中,阴部神经在阴道扩张期间特别容易受到损伤。这两种损伤模型可能有助于研究压力性尿失禁的病理生理学。