Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Neurogastroenterol Motil. 2018 Apr;30(4):e13242. doi: 10.1111/nmo.13242. Epub 2017 Nov 16.
Fecal incontinence (FI) has a multifactorial pathophysiology with a severe social impact. The most common cause for FI is pudendal nerve damage, which mostly occurs in women during or after labor. A better understanding of the pathophysiology is required to optimize treatment of FI. In this study, we evaluate the use of a novel pelvic nerve damage rat model of FI.
This new model simulates the forces on the pelvic floor during labor by prolonged transvaginal, retro-uterine intrapelvic balloon distention in female rats. Number of fecal pellets produced per day and defecation pattern was compared between the experimental and control group for 2 weeks. The cages of the rats were divided in food, nesting and latrine areas to evaluate changes in defecation pattern. The FI Index (FII) was calculated to assess the ratio of fecal pellets between the non-latrine areas and the total number of pellets. A higher score represents more random distribution of feces outside the latrine area.
Total number of fecal pellets was higher in the experimental group as compared with the controls. In both groups most fecal pellets were deposited in the nesting area, which is closest to the food area. The experimental group deposited more fecal pellets in the latrine area and had a lower FII indicating less random distribution of feces outside the latrine area.
Transvaginal, retro-uterine intrapelvic balloon distention is a safe and feasible animal model simulating the human physiologic impact of labor by downwards pressure on the pelvic floor.
粪便失禁(FI)具有多因素的病理生理学,具有严重的社会影响。FI 的最常见原因是阴部神经损伤,这在分娩期间或之后在女性中很常见。需要更好地了解病理生理学,以优化 FI 的治疗。在这项研究中,我们评估了一种新的 FI 阴部神经损伤大鼠模型的应用。
这个新模型通过在雌性大鼠的阴道内、子宫后盆腔内长时间的球囊扩张来模拟分娩时对盆底的压力。在 2 周的时间里,比较实验组和对照组每天产生的粪便颗粒数和排便模式。将大鼠的笼子分为食物、巢穴和厕所区域,以评估排便模式的变化。FI 指数(FII)用于评估非厕所区域的粪便颗粒数与总颗粒数的比例。得分越高表示粪便在厕所区域外的随机分布越多。
实验组的粪便颗粒总数高于对照组。在两组中,大多数粪便颗粒都沉积在巢穴区域,这是最接近食物区域的地方。实验组在厕所区域沉积的粪便颗粒更多,FII 较低,表明粪便在厕所区域外的随机分布较少。
经阴道、子宫后盆腔内球囊扩张是一种安全可行的动物模型,通过对盆底的向下压力模拟了人类分娩时的生理影响。