Keirstead Hans S, Fedulov Vadim, Cloutier Frank, Steward Oswald, Duel Barry P
Reeve-Irvine Research Center, Department of Anatomy and Neurobiology, 2111 Gillespie Neuroscience Research Facility, College of Medicine, University of California Irvine, Irvine, CA 92697-4292, USA.
Exp Neurol. 2005 Jul;194(1):120-7. doi: 10.1016/j.expneurol.2005.01.027.
Suprasacral spinal cord injury induces changes in the mechanical and neuronal properties of the bladder resulting in bladder areflexia followed by bladder-sphincter dyssynergia and detrusor muscle hypertrophy, which lead to urinary retention and increased bladder size. These changes are most often quantified using highly skilled urodynamic techniques that involve catheterization. We investigated whether a hand-held digital ultrasound imaging system could monitor urinary retention in the bladder following spinal cord injury in adult rats. Our findings indicate that contusive spinal cord injury resulted in high residual bladder volumes that decreased and stabilized by 2 weeks post-injury but remained significantly higher than control bladder volumes up to 46 days post-injury (the longest time point examined). Post hoc analysis indicated that the degree of bladder function recovery recorded at the end of the study correlated with the degree of bladder function recovery recorded at 6 days post-injury, indicating that bladder function recovery can be predicted by analyzing bladder volume as early as 6 days post-injury. Bladder function recovery correlated with locomotor recovery as assessed using the BBB locomotor rating scale. While providing a noninvasive assessment of bladder function with no detrimental impact on locomotor function or assessment, this protocol provides researchers with a clinically relevant outcome measure for quantifying bladder function recovery after spinal cord injury or after experimental treatments for spinal cord injury.
骶上脊髓损伤会引起膀胱机械性能和神经性能的改变，导致膀胱无反射，随后出现膀胱括约肌协同失调和逼尿肌肥大，进而导致尿潴留和膀胱体积增大。这些变化通常使用涉及插管的高技能尿动力学技术进行量化。我们研究了手持数字超声成像系统是否可以监测成年大鼠脊髓损伤后膀胱中的尿潴留情况。我们的研究结果表明，挫伤性脊髓损伤导致膀胱残余尿量很高，在损伤后2周时尿量减少并稳定下来，但在损伤后长达46天（所检测的最长时间点）仍显著高于对照膀胱的尿量。事后分析表明，研究结束时记录的膀胱功能恢复程度与损伤后6天记录的膀胱功能恢复程度相关，这表明早在损伤后6天通过分析膀胱体积就可以预测膀胱功能恢复情况。膀胱功能恢复与使用BBB运动评分量表评估的运动恢复相关。该方案在对运动功能或评估无不利影响的情况下提供了对膀胱功能的非侵入性评估，为研究人员提供了一种临床上相关的结果指标，用于量化脊髓损伤后或脊髓损伤实验性治疗后的膀胱功能恢复情况。
