Saito M, Yoshikawa Y, Ohmura M, Yokoi K, Kondo A
Department of Urology, Nagoya University School of Medicine, Japan.
Urol Res. 1996;24(3):171-5. doi: 10.1007/BF00304081.
Functional restoration of the rat urinary bladder following subtotal cystectomy was studied via in vivo infusion cystometry and an in vitro whole bladder model. After the bladder had been separated from the prostate, subtotal cystectomy was achieved by ligating the bladder completely at a level just above the insertion of the ureters into the bladder. Bladder function was investigated immediately and 7, 14, and 28 days after surgery. Bladder weight was reduced to 17% that in sham-operated controls immediately after surgery, but recovered to 76% of that in controls 28 days after the operation. In vivo capacity also increased after surgery from 13% that of controls to 59% 28 days later. However, voiding pressure remained low (34% of control) 28 days later. An in vitro whole bladder study showed that the response to field stimulation decreased significantly on day 7, but had recovered considerably by day 28. The maximal response to bethanechol decreased significantly 7 days after surgery, but recovered thereafter. The response to phenylephrine increased significantly immediately after surgery, but gradually returned to the control level. An in vitro volume-pressure study showed that passive compliance of the cystectomized bladder decreased after surgery, but improved with time. The peak of the active pressure increase to field stimulation occurred at a low infusion volume immediately after surgery, but bladder capacity increased gradually until 28 days later, when the maximal active pressure was obtained. Our results suggest that restoration of the bladder following subtotal cystectomy may not derive simply from an expansion of the bladder wall. Functional alteration involving the bladder base was also observed.
通过体内灌注膀胱测压法和体外全膀胱模型，研究大鼠膀胱部分切除术后膀胱功能的恢复情况。将膀胱与前列腺分离后，在输尿管插入膀胱处上方水平完全结扎膀胱，实现膀胱部分切除术。在术后即刻以及术后7天、14天和28天对膀胱功能进行研究。术后即刻，膀胱重量降至假手术对照组的17%，但术后28天恢复至对照组的76%。体内膀胱容量术后也从对照组的13%增加至28天后的59%。然而，28天后排尿压力仍较低（为对照组的34%）。体外全膀胱研究表明，术后第7天对场刺激的反应显著降低，但到第28天已大幅恢复。术后7天对氨甲酰甲胆碱的最大反应显著降低，但此后恢复。术后即刻对去氧肾上腺素的反应显著增加，但逐渐恢复至对照水平。体外容量 - 压力研究表明，膀胱部分切除术后膀胱的被动顺应性降低，但随时间改善。术后即刻，对场刺激的主动压力增加峰值出现在低灌注量时，但膀胱容量逐渐增加，直至28天后获得最大主动压力。我们的结果表明，膀胱部分切除术后膀胱功能的恢复可能并非仅仅源于膀胱壁的扩张。还观察到涉及膀胱底部的功能改变。
