Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue ND20, Cleveland, OH, 44195, USA.
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Sci Rep. 2024 Mar 28;14(1):7444. doi: 10.1038/s41598-024-57493-1.
Urinary incontinence is a common complication following radical prostatectomy, as the surgery disturbs critical anatomical structures. This study explored how pudendal nerve (PN) injury affects urinary continence in male rats. In an acute study, leak point pressure (LPP) and external urethral sphincter electromyography (EMG) were performed on six male rats with an intact urethra, the urethra exposed (UE), the PN exposed (NE), and after PN transection (PNT). In a chronic study, LPP and EMG were tested in 67 rats 4 days, 3 weeks, or 6 weeks after sham PN injury, PN crush (PNC), or PNT. Urethras were assessed histologically. Acute PNT caused a significant decrease in LPP and EMG amplitude and firing rate compared to other groups. PNC resulted in a significant reduction in LPP and EMG firing rate 4 days, 3 weeks, and 6 weeks later. EMG amplitude was also significantly reduced 4 days and 6 weeks after PNC. Neuromuscular junctions were less organized and less innervated after PNC or PNT at all timepoints compared to sham injured animals. Collagen infiltration was significantly increased after PNC and PNT compared to sham at all timepoints. This rat model could facilitate preclinical testing of neuroregenerative therapies for post-prostatectomy incontinence.
尿失禁是根治性前列腺切除术后的常见并发症，因为手术会干扰关键的解剖结构。本研究探讨了阴部神经（PN）损伤如何影响雄性大鼠的尿控。在一项急性研究中，对 6 只具有完整尿道、暴露尿道（UE）、暴露阴部神经（NE）和阴部神经横断（PNT）的雄性大鼠进行漏点压（LPP）和尿道外括约肌肌电图（EMG）检查。在一项慢性研究中，在假 PN 损伤、PN 挤压（PNC）或 PNT 后 4 天、3 周或 6 周，对 67 只大鼠进行 LPP 和 EMG 测试。对尿道进行组织学评估。急性 PNT 与其他组相比，LPP 和 EMG 幅度和发射率显著降低。PNC 导致 LPP 和 EMG 发射率在 4 天、3 周和 6 周后显著降低。PNC 后 4 天和 6 周，EMG 幅度也显著降低。与假损伤动物相比，PNC 或 PNT 后所有时间点的神经肌肉接头组织排列和神经支配均减少。与 sham 相比，PNC 和 PNT 后所有时间点的胶原浸润均显著增加。这种大鼠模型可以促进神经再生疗法在前列腺切除术后尿失禁中的临床前测试。
