Department of Biomedical Engineering, Florida International University, Miami, Florida, USA.
Neurourol Urodyn. 2023 Sep;42(7):1532-1546. doi: 10.1002/nau.25243. Epub 2023 Jul 9.
The central nervous system (CNS) regulates lower urinary tract reflexes using information from sensory afferents; however, the mechanisms of this process are not well known. Pressure and volume were measured at the onset of the guarding and micturition reflexes across a range of infusion rates to provide insight into what the CNS is gauging to activate reflexes.
Female Sprague Dawley rats were anesthetized with urethane for open outlet cystometry. A set of 10 infusion rates (ranging 0.92-65.5 mL/h) were pseudo-randomly distributed across 30 single-fill cystometrograms. Bladder pressure and external urethral sphincter electromyography were used for the determination of the onset of the micturition and guarding reflexes, respectively. The bladder volume at the onset of both reflexes was estimated from the total infusion rate during a single fill.
In response to many single-fill cystometrograms, there was an increased volume the bladder could store without a significant increase in pressure. Volume was adjusted for this effect for the analysis of how pressure and volume varied with infusion rate at the onset of the micturition and guarding reflexes. In 25 rats, the micturition reflex was evoked at similar volumes across all infusion rates, whereas the pressure at micturition reflex onset increased with increasing infusion rates. In 11 rats, the guarding reflex was evoked at similar pressures across infusion rates, but the volume decreased with increasing infusion rates.
These results suggest that the CNS is interpreting volume from the bladder to activate the micturition reflex and pressure from the bladder to activate the guarding reflex.
中枢神经系统 (CNS) 通过来自感觉传入的信息来调节下尿路反射;然而,这个过程的机制还不是很清楚。通过测量在一系列输注速率下的保护和排尿反射开始时的压力和容量,来深入了解 CNS 正在测量什么以激活反射。
雌性 Sprague Dawley 大鼠用氨基甲酸乙酯麻醉进行开放式出口膀胱测压。一组 10 个输注速率(范围 0.92-65.5ml/h)在 30 个单次填充膀胱测压图中随机分布。膀胱压力和尿道外括约肌肌电图分别用于确定排尿和保护反射的开始。从单次填充过程中的总输注速率估算出两种反射开始时的膀胱容积。
在许多单次填充膀胱测压图中,膀胱可以存储的容量增加而压力没有显著增加。为了分析压力和体积如何随排尿和保护反射开始时的输注速率而变化,对体积进行了调整以消除这种影响。在 25 只大鼠中,在所有输注速率下,排尿反射在相似的膀胱容量下被诱发,而在排尿反射开始时的压力随着输注速率的增加而增加。在 11 只大鼠中,在输注速率下,保护反射在相似的压力下被诱发,但随着输注速率的增加,膀胱容量减少。
这些结果表明,CNS 正在解释来自膀胱的容量以激活排尿反射,并解释来自膀胱的压力以激活保护反射。