Department of Postgraduate Education, Jinzhou Medical University, Jinzhou, Liaoning Province, China.
Center for Reproductive Medicine, Department of Gynecology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
PLoS One. 2024 Oct 11;19(10):e0311559. doi: 10.1371/journal.pone.0311559. eCollection 2024.
To establish experimental models of radical hysterectomy based on Querleu-Morrow classification, and clarify the quantitative evaluation of pelvic neural injuries and acute voiding changes postoperatively.
Female Sprague Dawley rats were randomized and received sham operation, type A, B1, C1 and C2 radical hysterectomies (as the injury gradually increased), respectively. The excised specimens were collected for hematoxylin and eosin staining and Pgp9.5 (pan-neuronal marker) immunohistochemistry to evaluate the facial and neural resection of paracervix. At 21 days after operation, 5 rats in each group were used for urine spot test, awake cystometry and leak point pressure test, and the other 5 ones were used for hematoxylin and eosin staining of bladder and pelvic neural plane, and Masson's trichrome staining of bladder.
Paracervical Pgp9.5 immunohistochemistry revealed that the resected neural area in C2 group was significantly larger than that in type A, B1, and C1 groups. Compared with type A and B1 groups, the excised paracervical facial area was significant higher in type C1 and C2 groups. The occurrence of urinary retention was 0%, 10%, 40% and 100% in type A, B1, C1 and C2 groups, respectively, which was further confirmed by average residual volume. The incidence of neurogenic bladder and its severity gradually increased from type A to type C2 groups, consistent with the findings of leakage point pressure, bladder size, bladder weight, pathological changes and collagen deposition. Neuropathological evaluation revealed neural injuries involved the main components of pelvic neural plane.
The novel rat models of radical hysterectomy based on Querleu-Morrow classification revealed the structural and functional changes of voiding after operation, which reflected the situation in humans.
建立基于 Querleu-Morrow 分类的根治性子宫切除术实验模型，阐明术后盆腔神经损伤和急性排尿变化的定量评估。
将雌性 Sprague Dawley 大鼠随机分为假手术组、A 型、B1 型、C1 型和 C2 型（损伤逐渐增加）根治性子宫切除术组。切除标本行苏木精-伊红染色和 Pgp9.5（神经元标志物）免疫组织化学染色，评估宫颈旁神经和面神经的切除情况。术后 21 天，每组各取 5 只大鼠进行尿斑试验、清醒膀胱测压和漏点压力试验，另取 5 只大鼠进行膀胱和盆腔神经平面苏木精-伊红染色和膀胱 Masson 三色染色。
宫颈旁 Pgp9.5 免疫组织化学染色显示，C2 组切除的神经面积明显大于 A、B1 和 C1 组。与 A 组和 B1 组相比，C1 组和 C2 组切除的宫颈旁面区明显更高。尿潴留的发生率分别为 A、B1、C1 和 C2 组的 0%、10%、40%和 100%，平均残余尿量进一步证实了这一点。神经源性膀胱的发生率及其严重程度从 A 型逐渐增加到 C2 型，与漏点压力、膀胱大小、膀胱重量、病理变化和胶原沉积的发现一致。神经病理学评估显示，神经损伤累及盆腔神经平面的主要成分。
基于 Querleu-Morrow 分类的新型根治性子宫切除术大鼠模型揭示了术后排尿的结构和功能变化，反映了人类的情况。
