Bansal Utsav, Fuller Thomas W, Jiang Xuewen, Bandari Jathin, Zhang Zhaocun, Shen Bing, Wang Jicheng, Roppolo James R, de Groat William C, Tai Changfeng
Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania.
Department of Urology, Qilu Hospital, Shandong University, Jinan, P.R. China.
Neurourol Urodyn. 2017 Aug;36(6):1496-1502. doi: 10.1002/nau.23159. Epub 2016 Oct 24.
To determine the spinal segmental afferent contributions to tibial and pudendal inhibition of bladder overactivity.
Intravesical infusion of 0.5% acetic acid was used to irritate the bladder and induce bladder overactivity in anesthetized cats. Tibial or pudendal nerve stimulation was used to suppress the bladder overactivity and increase bladder capacity during cystometry. L5-S3 dorsal roots ipsilateral to the stimulation were exposed by a laminectomy and transected sequentially during the experiments to determine the role of individual dorsal roots in tibial or pudendal neuromodulation.
Transection of L5 dorsal root had no effect. Transection of L6 dorsal root in four cats produced an average 18% reduction in tibial inhibition, which is not a significant change when averaged in the group of 10 cats. Transection of L7 dorsal root completely removed the tibial inhibition without changing reflex bladder activity or pudendal inhibition. Transection of S1 dorsal root reduced the pudendal inhibition, after which transection of S2 dorsal root completely removed the pudendal inhibition. Transection of S3 dorsal root had no effect. The control bladder capacity was increased only by transection of S2 dorsal root.
This study in cats revealed that tibial and pudendal neuromodulation of reflex bladder overactivity depends on activation of primary afferent pathways that project into different spinal segments. This difference may be related to the recent observation in cats that the two types of neuromodulation have different mechanisms of action.
确定脊髓节段传入神经对膀胱过度活动的胫神经和阴部神经抑制作用的贡献。
在麻醉猫中，通过膀胱内灌注0.5%醋酸刺激膀胱并诱发膀胱过度活动。在膀胱测压期间，使用胫神经或阴部神经刺激来抑制膀胱过度活动并增加膀胱容量。通过椎板切除术暴露与刺激同侧的L5-S3背根，并在实验过程中依次切断，以确定各个背根在胫神经或阴部神经调节中的作用。
切断L5背根无影响。切断4只猫的L6背根后，胫神经抑制平均降低18%，在10只猫的组中平均时这不是显著变化。切断L7背根完全消除了胫神经抑制，而未改变反射性膀胱活动或阴部神经抑制。切断S1背根降低了阴部神经抑制，之后切断S2背根完全消除了阴部神经抑制。切断S3背根无影响。仅切断S2背根可增加对照膀胱容量。
这项在猫身上的研究表明，反射性膀胱过度活动的胫神经和阴部神经调节取决于投射到不同脊髓节段的初级传入通路的激活。这种差异可能与最近在猫身上观察到的这两种神经调节具有不同作用机制有关。
