Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung, Medical Center, Keelung, Taiwan, Republic of China.
Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China.
Sci Rep. 2020 Feb 3;10(1):1718. doi: 10.1038/s41598-020-58604-4.
To determine the association of opening the paravesical space in relation to its occurrence of de novo SUI in an animal model. Thirty five female Sprague Dawley rats were divided into 5 groups of 7 rats each: Control group, Sham groups(F, H), and Study groups(MF, MH). Groups labeled with "F" had the paravesical space opened, "H" had tissue dissection with no opening of the space, and "M" had mesh implanted inside the vaginal wall. Urodynamic studies, immunohistochemical analysis, and western blot were done at day 40. The mean weight and age of 35 rats were 302.1 ± 25.1 grams and 12.8 ± 1.2 weeks old. No significant differences were noted among the control, Sham F, Sham H, Study MF, and Study MH on the voiding pressure and voided volume. The Sham F and Study MF (opened paravesical space) groups had significantly lower values on leak point pressures (LPP) (p = 0.026; p < 0.001) and shorter voiding intervals (p = 0.032; p = 0.005) when compared to other groups. Immunohistochemical analysis showed IL-1 and TNF-α to be intensely increased for the Study MF group (p = 0.003; p = <0.001). MMP-2 and CD 31 markers were also significantly higher in the Study MH and MF group. NGF expression was significantly increased in the Study MF and Sham F groups. Thus, opening of the paravesical space causes an increased inflammatory reaction, which leads to tissue destruction and lower urinary tract dysfunction, exemplified in the study with low leak point pressure and shortened voiding intervals.
确定在动物模型中切开膀胱旁间隙与新发压力性尿失禁(SUI)发生的相关性。
35 只雌性 Sprague Dawley 大鼠分为 5 组,每组 7 只:对照组、假手术组(F、H 组)和研究组(MF、MH 组)。F 组切开膀胱旁间隙,H 组只进行组织解剖而不切开间隙,M 组将网片植入阴道壁内。第 40 天进行尿动力学研究、免疫组化分析和 Western blot 分析。35 只大鼠的平均体重和年龄分别为 302.1±25.1 克和 12.8±1.2 周。在排尿压力和排尿量方面,对照组、假手术 F 组、假手术 H 组、研究 MF 组和研究 MH 组之间无显著差异。与其他组相比,假手术 F 组和研究 MF 组(切开膀胱旁间隙)的漏点压(LPP)显著降低(p=0.026;p<0.001),排尿间隔更短(p=0.032;p=0.005)。免疫组化分析显示,研究 MF 组的白细胞介素-1(IL-1)和肿瘤坏死因子-α(TNF-α)表达显著增加(p=0.003;p<0.001)。研究 MH 组和 MF 组的 MMP-2 和 CD31 标志物也显著升高。研究 MF 组和假手术 F 组的神经生长因子(NGF)表达显著增加。因此,切开膀胱旁间隙会引起炎症反应增强,导致组织破坏和下尿路功能障碍,表现在研究中即漏点压低和排尿间隔缩短。