Lin Guiting, Van Kuiken Michelle, Wang Guifang, Banie Lia, Tan Yan, Zhou Feng, Wang Zhao, Chen Yinwei, Zhang Yingchun, Lue Tom F
Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, USA.
Department of Biomedical Engineering, University of Houston, Houston, TX, USA.
Transl Androl Urol. 2022 May;11(5):595-606. doi: 10.21037/tau-22-30.
The mechanisms of the microenergy acoustic pulse (MAP) therapy on restoring structure and function of pelvic floor muscles (PFM) after simulated birth injury are not well understood.
A total 24 female Sprague-Dawley rats were randomly grouped into sham control (sham), vaginal balloon dilation and ovariectomy (VBDO), VBDO + β-aminopropionitrile (BAPN, an irreversible LOX inhibitor), and VBDO + BAPN and treated with MAP (n=6 in each group). The MAP therapy was administered 2 times per week for 4 weeks with 1-week washout, the functional and histological studies were conducted in all 24 rats. The viscoelastic behavior of the PFM, including iliococcygeus (IC) and pubococcygeus (PC), was examined with a biomechanical assay. The structure of the PFM was assessed by immunofluorescence and Masson's trichrome staining.
The leak point pressure (LPP) assay demonstrated that the MAP therapy group had higher LPPs compared to that of VBDO and BAPN groups. In the sham group, the muscular stiffness (K) of IC muscle was significantly higher than that of PC muscle while the pelvic floor muscle rebound activity (MRA) of PC muscle was stronger than that of IC muscle (291.26±45.33 and 241.18±14.23 N/cm, respectively). Both VBDO and BAPN decreased the MRA and increased the K in both IC and PC. Histologic examination revealed increased fibrous tissue (collagen) and degeneration of muscle fibers in both VBDO and BAPN groups. MAP therapy significantly reduced the collagen content and improved the architecture of muscle fibers.
MAP appears to restore the structure and function of PFM by regenerating muscular fibers and improving biomechanical properties in an animal model of simulated birth injury.
微能量声脉冲(MAP)疗法对模拟分娩损伤后盆底肌肉(PFM)结构和功能恢复的机制尚不清楚。
将24只雌性Sprague-Dawley大鼠随机分为假手术对照组(假手术组)、阴道球囊扩张加卵巢切除术(VBDO组)、VBDO + β-氨基丙腈(BAPN,一种不可逆的赖氨氧化酶抑制剂)组以及VBDO + BAPN并接受MAP治疗组(每组n = 6)。MAP治疗每周进行2次,共4周,中间有1周的洗脱期,对所有24只大鼠进行功能和组织学研究。通过生物力学测定法检测包括髂尾肌(IC)和耻骨尾骨肌(PC)在内的PFM的粘弹性行为。通过免疫荧光和Masson三色染色评估PFM的结构。
漏点压力(LPP)测定表明,与VBDO组和BAPN组相比,MAP治疗组的LPP更高。在假手术组中,IC肌的肌肉硬度(K)显著高于PC肌,而PC肌的盆底肌肉反弹活动(MRA)比IC肌更强(分别为291.26±45.33和241.18±14.23 N/cm)。VBDO和BAPN均降低了IC和PC的MRA并增加了K。组织学检查显示,VBDO组和BAPN组的纤维组织(胶原蛋白)增加且肌纤维变性。MAP治疗显著降低了胶原蛋白含量并改善了肌纤维结构。
在模拟分娩损伤的动物模型中,MAP似乎通过再生肌纤维和改善生物力学特性来恢复PFM的结构和功能。