Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Department of Urology, Daegu Fatima Hospital, Daegu, Republic of Korea.
Am J Physiol Renal Physiol. 2019 Oct 1;317(4):F781-F788. doi: 10.1152/ajprenal.00197.2019. Epub 2019 Jul 17.
The present study evaluated real-time changes in urethral pressure during the storage phase using a rat model with stress urinary incontinence (SUI) induced by simulated multiple birth traumas and investigated the relationship between urethral continence function and dynamic parameters associated with the changes in urethral pressure. Sprague-Dawley rats were divided into the following two groups: the sham group, which underwent three catheterizations of the vagina without distension at 2-wk intervals, and the vaginal distension (VD) group, which underwent three VDs at 2-wk intervals. After transection of the T8-T9 spinal cord, simultaneous bladder and urethral pressure recordings were performed during intravesical pressure elevation. Urodynamic parameters such as leak point pressure (LPP), urethral baseline pressure (UBP), maximum urethral pressure (MUP), the MUP-UBP differential (dUP) during intravesical pressure elevation, the bladder pressure when urethral contraction begins (Puc), and the bladder pressure at bladder neck opening (Pno) were then measured and compared. Compared with the sham group, LPP, UBP, dUP, MUP, Puc, and Pno were significantly decreased in the VD group. Pressure differences between LPP and Pno and between LPP and UBP (LPP-UBP) were also significantly different in the two groups. However, difference values of LPP and MUP or Pno and UBP were not altered after VD. Our new methods of simultaneous recordings of dynamic changes in bladder and urethral pressures are useful to fully evaluate the functional alterations in urethral continence function in the SUI model induced by multiple VDs. Moreover, LPP-UBP values, which correspond to the difference between Valsalva LPP and maximum urethral closure pressure in clinical urodynamics, would be useful to evaluate the impaired urethral continence function after simulated birth traumas in animal models.
本研究通过模拟多次分娩创伤诱导压力性尿失禁(SUI)的大鼠模型,评估了储存期尿道压力的实时变化,并研究了尿道控尿功能与与尿道压力变化相关的动态参数之间的关系。将 Sprague-Dawley 大鼠分为以下两组:假手术组,在 2 周间隔内进行三次阴道无扩张的导管插入术;阴道扩张(VD)组,在 2 周间隔内进行三次 VD。在 T8-T9 脊髓横断后,在膀胱内压升高的同时进行膀胱和尿道压力同步记录。测量并比较尿动力学参数,如漏点压(LPP)、尿道基础压(UBP)、最大尿道压(MUP)、膀胱内压升高时的 MUP-UBP 差值(dUP)、尿道收缩开始时的膀胱压(Puc)和膀胱颈开放时的膀胱压(Pno)。与假手术组相比,VD 组的 LPP、UBP、dUP、MUP、Puc 和 Pno 显著降低。两组之间的 LPP 和 Pno 之间以及 LPP 和 UBP 之间的压力差异(LPP-UBP)也有显著差异。然而,VD 后 LPP 和 MUP 或 Pno 和 UBP 的差值值没有改变。我们同时记录膀胱和尿道压力动态变化的新方法对于充分评估多次 VD 诱导的 SUI 模型中尿道控尿功能的功能改变非常有用。此外,LPP-UBP 值与临床尿动力学中 Valsalva LPP 和最大尿道闭合压之间的差值相对应,可用于评估动物模型中模拟分娩创伤后受损的尿道控尿功能。