Cheng C L, de Groat William C
Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung 407, Taiwan, ROC.
Exp Neurol. 2004 Jun;187(2):445-54. doi: 10.1016/j.expneurol.2004.02.014.
The role of capsaicin-sensitive afferents in neurogenic voiding dysfunction was studied in chronic spinal cord injured rats (SCI). Cystometry and external urethral sphincter (EUS) electromyography were performed on 2 consecutive days after induction of urethane anesthesia in SCI rats 6-8 weeks after spinal cord injury. SCI rats exhibited voiding abnormalities including: non-voiding contractions (NVCs) before micturition, increased volume threshold (VT) for initiating voiding, increased amplitude and duration of voiding contractions, decreased voiding efficiency, increased residual urine, and changes in the pattern of the EUS-EMG. In SCI rats, the EUS electromyogram (EUS-EMG) consisted of more prominent tonic activity, shorter periods of bursting activity, and a reduction in the ratio of silent to active periods during bursting. These changes were more prominent during deeper levels of anesthesia on day 1. Capsaicin (125 mg/kg, s.c., 4 days before urodynamic examination) reduced VT and the number of NVCs, decreased the amplitude and duration of voiding contractions, partially normalized the pattern of EUS-EMG activity, and improved the voiding efficiency on day 1 after induction of anesthesia but not on day 2. Capsaicin treatment increased the percentage of animals (from 55% to 80%) that voided on day 1. The results indicate that capsaicin-sensitive C-fiber bladder afferents are not essential for reflex micturition in SCI rats. However, these afferents do contribute to overactivity of the bladder and detrusor sphincter dyssynergia in deeply anesthetized SCI rats.
在慢性脊髓损伤大鼠(SCI)中研究了辣椒素敏感传入神经在神经源性排尿功能障碍中的作用。在脊髓损伤6 - 8周后的SCI大鼠中,在诱导氨基甲酸乙酯麻醉后连续两天进行膀胱测压和尿道外括约肌(EUS)肌电图检查。SCI大鼠表现出排尿异常,包括:排尿前的无排尿收缩(NVCs)、启动排尿的容量阈值(VT)增加、排尿收缩的幅度和持续时间增加、排尿效率降低、残余尿量增加以及EUS - EMG模式的改变。在SCI大鼠中,EUS肌电图(EUS - EMG)表现为更明显的紧张性活动、爆发性活动期缩短以及爆发期间静息期与活动期的比例降低。这些变化在第1天更深麻醉水平时更为明显。辣椒素(125 mg/kg,皮下注射,尿动力学检查前4天)降低了VT和NVCs的数量,减少了排尿收缩的幅度和持续时间,部分使EUS - EMG活动模式正常化,并在麻醉诱导后的第1天提高了排尿效率,但在第2天没有。辣椒素治疗增加了第1天排尿的动物百分比(从55%增加到80%)。结果表明,辣椒素敏感的C纤维膀胱传入神经对于SCI大鼠的反射性排尿并非必不可少。然而,这些传入神经确实导致了深度麻醉的SCI大鼠膀胱过度活动和逼尿肌括约肌协同失调。