切断双侧阴部神经建立女性压力性尿失禁的动物模型及效果评价

Establishment and evaluation of an animal model of stress urinary incontinence by bilateral transection of the pudendal nerve

目的探讨切断双侧阴部神经建立压力性尿失禁(SUI)动物模型的可行性。方法采用双侧阴部神经离断法制备大鼠SUI动物模型。模拟人体尿动力学检查的方法,测定实验动物的最大膀胱容量(MBV)、腹压漏尿点压(ALPP)、最大尿道闭合压(MUCP)及功能性尿道长度(FUL),证实SUI动物模型制作成功。并通过HE染色、Masson特殊染色、Mallory特殊染色、电镜超微结构对大鼠尿道横纹肌性括约肌的显微解剖进行观察。结果双侧阴部神经离断法可成功建立大鼠SUI模型。尿动力学检测结果:模型建立后大鼠平均最大膀胱容量增加(0.89±0.04)ml(P<0.01),平均腹压漏尿点压下降(15.46±5.49)cm H_2O(P<0.01),平均最大尿道闭合压和功能性尿道长度下降(7.97±3.25)cm H_2O和(0.69±0.32)cm(P<0.01)。建模后尿道及其周围组织形态学:尿道括约肌排列松散,部分肌肉有断裂现象,肌层变薄;结缔组织所占比重增加,胶原纤维稀疏,排列紊乱。结论通过双侧阴部神经离断的方法,成功建立了SUI动物模型,为后续实验奠定了基础。尿道横纹括约肌呈封闭环形分布于雌性大鼠尿道的中外段,提示此处为控尿机制的主要部位。

Objective To evaluate the feasibility and validity of establishing animal model of stress urinary incontinence （SUI） by bilateral transection of the pudendal nerve . Methods Bilateral pudendal nerve transaction was preparation of rat animal model of SUI. Simulated human body urodynamic method of the maximum bladder capacity of experimental animals, abdominal leak point pressure （ALPP）, maximum urethral closure pressure （MUCP）, and the functional length of the urethra （FUL） ;and HE staining, Masson special stain, Mallory staining and special nature of the urethral sphincter striated muscle ultrastructure in transmission electron microscopy studies confirmed the successful production of animal models of SUI. Results Bilateral pudendal nerve transection of the method can be successfully produced in rat model of SUI.Compared with those at baseline, the average quantity of maximum bladder volume （MBV） were increased by （0.89-t-0.04） ml （P 〈 0.01） ; Abdomen pressure leak point pressure （ALPP） were significantly decreased by （15.46±5.49） cmH2O, respectively （P 〈 0.01 ） .MUCP and FUL were decreased by （7.97±3.25） cmH20 and （0.69±0.32） cm,respectively （P 〈 0.01） . Modeling of the posterior urethra and surrounding tissue morphology： sphincter loose arrangement of some muscles fracture phenomenon, muscle thinning; the proportion of connective tissue increase in sparse collagen fibers arranged in disorder. Conclusion Rats models of SUI were obtained by transaction of bilateral pudendal nerve,which established the foundation of extending experiment. The striated urethral sphincter of female rats was considered as a closed ring surrounding the urethral from the middle to the distal. It suggests that this may be the main site of urinary continence mechanism.