Miyazato Minoru, Sugaya Kimio, Nishijima Saori, Ashitomi Katsuhiro, Ohyama Choko, Ogawa Yoshihide
Department of Urology, Faculty of Medicine, University of the Ryukyus and Nakagami Hospital, Okinawa, Japan.
J Urol. 2004 Mar;171(3):1353-6. doi: 10.1097/01.ju.0000099840.09816.22.
We examined the influence of rectal distention on the spinobulbospinal micturition reflex and the mechanism underlying the inhibition of bladder contraction.
A total of 22 female Sprague-Dawley rats were used in this study. Using urethane anesthesia isovolumetric cystometry was performed before and after distention of the rectum by inflation of a rectal balloon (0 to 3 cm3), followed by the intrathecal injection of strychnine (a glycine receptor antagonist, 0.001 to 10 microg) and/or bicuculline (a gamma-aminobutyric acid(A) receptor antagonist, 0.001 to 1 microg) at the lumbosacral level of the spinal cord.
Rectal distention (1.5 to 3.0 cm3) prolonged the interval, decreased the amplitude and shortened the duration of bladder contraction and finally almost abolished bladder activity. After intrathecal injection of strychnine or bicuculline in animals with inhibition of the bladder by rectal distention the interval and duration of bladder contraction returned to baseline but amplitude only recovered to 47% to 54% of the control level. However, simultaneous intrathecal injection of strychnine and bicuculline (0.001 microg each) restored amplitude to the control level. There were no differences between strychnine and bicuculline with respect to their effects on the interval, amplitude and duration of bladder contraction.
An inhibitory rectovesical reflex exists in the lumbosacral cord of rats. The afferent limb of the spinobulbospinal micturition reflex pathway may be additionally and redundantly inhibited by glycinergic and GABAergic mechanisms, while the efferent limb of this pathway may be synergistically inhibited by these mechanisms.
我们研究了直肠扩张对脊髓-延髓-脊髓排尿反射的影响以及膀胱收缩抑制的潜在机制。
本研究共使用了22只雌性Sprague-Dawley大鼠。采用氨基甲酸乙酯麻醉,在通过直肠球囊充气(0至3立方厘米)扩张直肠前后进行等容膀胱测压,随后在脊髓腰骶水平鞘内注射士的宁(一种甘氨酸受体拮抗剂,0.001至10微克)和/或荷包牡丹碱(一种γ-氨基丁酸(A)受体拮抗剂,0.001至1微克)。
直肠扩张(1.5至3.0立方厘米)延长了间隔时间,降低了膀胱收缩幅度并缩短了其持续时间,最终几乎消除了膀胱活动。在直肠扩张抑制膀胱的动物中鞘内注射士的宁或荷包牡丹碱后,膀胱收缩的间隔时间和持续时间恢复到基线水平,但幅度仅恢复到对照水平的47%至54%。然而,同时鞘内注射士的宁和荷包牡丹碱(各0.001微克)可使幅度恢复到对照水平。士的宁和荷包牡丹碱对膀胱收缩的间隔时间、幅度和持续时间的影响无差异。
大鼠腰骶脊髓中存在抑制性直肠-膀胱反射。脊髓-延髓-脊髓排尿反射通路的传入支可能受到甘氨酸能和γ-氨基丁酸能机制的额外和冗余抑制,而该通路的传出支可能受到这些机制的协同抑制。