Zhou Chengyu, Zhu Liping, Liu Zhaoxue, Tong Yao, Xu Yuting, Jiang Li, Li Xuhong
Department of Rehabilitation Medicine, The 3rd Xiangya Hospital, Central South University, Changsha, China.
Postdoctoral Research Station of Basic Medicine, The 3rd Xiangya Hospital, Central South University, Changsha, China.
Transl Androl Urol. 2024 May 31;13(5):657-666. doi: 10.21037/tau-23-675. Epub 2024 May 27.
Stress urinary incontinence (SUI) is the most ubiquitous form of urinary incontinence in women. The therapeutic management of patients with SUI is challenging. The aim of this study is to evaluate the efficacy of whole body vibration training (WBVT) for SUI.
Thirty-five female rats were randomly divided into a sham group (Sham group, n=5), SUI + WBVT group (n=15) and SUI + whole body rest group (SUI + WBR group, n=15). The SUI + WBVT group was trained as follows: frequency 30 Hz, amplitude four mm, one min/repeat, four min rest, repeated 10 times, five days/week. After the intervention, five rats were taken on the 7, 14 and 21 day to observe the urodynamic changes, levator ani muscle and dorsal root ganglia (DRG) morphology, and to observe the expression of neurotrophic factor-3/tyrosine protein kinase C (NT-3/TrkC) by Western blot.
The urodynamic results showed that the difference in bladder leak point pressure/abdominal leak point pressure (BLPP/ALPP) between the Sham group and the SUI + WBR group was statistically significant (P<0.001) on 7 day, indicating successful modeling. The BLPP/ALPP of the SUI + WBVT group and the SUI + WBR group improved on 7, 14, and 21 day, and the BLPP/ALPP of SUI + WBVT group was higher than the SUI + WBR group. Compared with the Sham group, pathological changes appeared in the muscle shuttles in the SUI + WBVT group and SUI + WBR group. Western blot showed a gradual up-regulation of NT-3/TrkC.
WBVT can be used to treat SUI by affecting the expression of NT-3/TrkC, improving the structural morphology of the proprioceptors, and restoring the urinary control function. This study provides evidence for the clinical practice of WBVT. Future studies could further refine the behavioral and electrophysiological aspects of the assessment.
压力性尿失禁（SUI）是女性中最常见的尿失禁形式。SUI患者的治疗管理具有挑战性。本研究旨在评估全身振动训练（WBVT）对SUI的疗效。
35只雌性大鼠随机分为假手术组（假手术组，n = 5）、SUI + WBVT组（n = 15）和SUI + 全身休息组（SUI + WBR组，n = 15）。SUI + WBVT组按以下方式训练：频率30Hz，振幅4mm，1分钟/重复，休息4分钟，重复10次，每周5天。干预后，在第7、14和21天各取5只大鼠，观察尿动力学变化、肛提肌和背根神经节（DRG）形态，并通过蛋白质免疫印迹法观察神经营养因子-3/酪氨酸蛋白激酶C（NT-3/TrkC）的表达。
尿动力学结果显示，假手术组与SUI + WBR组在第7天的膀胱漏点压力/腹压漏点压力（BLPP/ALPP）差异有统计学意义（P < 0.001），表明造模成功。SUI + WBVT组和SUI + WBR组的BLPP/ALPP在第7、14和21天有所改善，且SUI + WBVT组的BLPP/ALPP高于SUI + WBR组。与假手术组相比，SUI + WBVT组和SUI + WBR组的肌梭出现病理改变。蛋白质免疫印迹法显示NT-3/TrkC逐渐上调。
WBVT可通过影响NT-3/TrkC的表达、改善本体感受器的结构形态以及恢复控尿功能来治疗SUI。本研究为WBVT的临床应用提供了证据。未来的研究可以进一步完善评估的行为学和电生理学方面。
