Department of Urology, University of California San Diego Medical Center, San Diego, California.
Department of Medicine, University of California San Diego Medical Center, San Diego, California.
Am J Physiol Gastrointest Liver Physiol. 2022 Jan 1;322(1):G134-G141. doi: 10.1152/ajpgi.00295.2021. Epub 2021 Dec 8.
External anal sphincter (EAS), external urethral sphincters, and puborectalis muscle (PRM) have important roles in the genesis of anal and urethral closure pressures. In the present study, we defined the contribution of these muscles alone and in combination with the sphincter closure function using a rabbit model and a high-definition manometry (HDM) system. A total of 12 female rabbits were anesthetized and prepared to measure anal, urethral, and vaginal canal pressures using a HDM system. Pressure was recorded at rest and during electrical stimulation of the EAS and PRM. A few rabbits ( = 6) were subjected to EAS injury and the impact of EAS injury on the closure pressure profile was also evaluated. Anal, urethral, and vaginal canal pressures recorded at rest and during electrical stimulation of EAS and PRM demonstrated distinct pressure profiles. EAS stimulation induced anal canal pressure increase, whereas PRM stimulation increased the pressures in all the three orifices. Electrical stimulation of EAS after injury resulted in about 19% decrease in anal canal pressure. Simultaneous electrical stimulation of EAS and PRM resulted in an insignificant increase of individual anal canal pressures when compared with pressures recorded after EAS or PRM stimulations alone. Our data confirm that HDM is a viable system to measure dynamic pressure changes within the three orifices and to define the role of each muscle in the development of closure pressures within these orifices in preclinical studies. We anticipate that with this new HDM technology, physiological changes within these orifices may be redefined using the extensive data that are generated from 96 sensors. When compared with conventional methods, HDM offers the advantages of an increased response rate, as well as the utilization of 96 circumferential sensors to simultaneously measure pressure along the three orifices. Our findings suggest a potential use of this technology to better define urinary leak point pressure.
肛门外括约肌（EAS）、尿道外括约肌和耻骨直肠肌（PRM）在肛门和尿道闭合压力的产生中具有重要作用。在本研究中，我们使用兔模型和高清晰度测压（HDM）系统来定义这些肌肉单独和联合括约肌功能的贡献。
总共 12 只雌性兔子被麻醉并准备使用 HDM 系统测量肛门、尿道和阴道的压力。在休息时和 EAS 和 PRM 电刺激时记录压力。一些兔子（= 6）接受了 EAS 损伤，还评估了 EAS 损伤对闭合压力曲线的影响。在休息时和 EAS 和 PRM 电刺激时记录的肛门、尿道和阴道压力呈现出不同的压力曲线。EAS 刺激引起肛门内压升高，而 PRM 刺激则增加了三个开口的压力。EAS 损伤后的电刺激导致肛门内压下降约 19%。EAS 和 PRM 的同时电刺激与单独 EAS 或 PRM 刺激后的压力相比，对个体肛门内压的增加没有显著影响。
我们的数据证实，HDM 是一种可行的系统，可以测量三个开口内的动态压力变化，并在临床前研究中定义每个肌肉在这些开口内闭合压力发展中的作用。我们预计，通过这种新的 HDM 技术，使用从 96 个传感器生成的广泛数据，可能会重新定义这些开口内的生理变化。与传统方法相比，HDM 具有增加的响应速度以及利用 96 个圆周传感器同时测量三个开口沿线压力的优点。
我们的研究结果表明，该技术可能有潜力更好地定义尿失禁点压力。
