阴部神经电刺激对大鼠膀胱过度活动症的治疗作用

Effect of pudendal nerve stimulation on overactive bladder in rats

目的探讨阴部神经电刺激在前列腺素E_2(PGE_2)大鼠膀胱过度活动症(OAB)模型中的治疗作用。方法 17只雌性SD大鼠采用乌拉坦麻醉,采用随机数字表法分为PGE_2组(11只)和空白基质溶液组(6只),PGE_2组大鼠膀胱内连续灌注100μmol/L PGE_2溶液,空白基质溶液组大鼠膀胱内连续灌注空白基质溶液,记录两组大鼠灌注前后膀胱测压(CMG)参数和尿道外括约肌(EUS)肌电图(EMG)参数。PGE_2组大鼠在此基础上引入阴部神经电刺激,观察其对CMG参数的影响。结果膀胱内灌注PGE_2导致膀胱容量减少,排尿效率增加,但最大收缩压、收缩持续时间、膀胱收缩AUC没有变化。阴部神经电刺激能够逆转PGE_2诱导的膀胱容量变化,并在特定的刺激条件(10Hz、1.0T)下增加EUS EMG。结论膀胱内灌注PGE_2导致大鼠膀胱容量降低,阴部神经电刺激逆转了PGE_2诱导的膀胱容量变化,阴部神经电刺激有望成为治疗OAB的新型方法。

Objective To investigate the effect of pudendal nerve stimulation on overactive bladder(OAB) in rats.Methods Seventeen female Sprague-Dawley rats were randomly divided into study group( n=11) and control group(n=6).Intravesical instillation of prostaglandin E2(PGE2) or normal saline was given to study group and control group under urethane anesthesia, respectively. The cystometrogram(CMG) and electromyography(EMG) of external urethral sphincter(EUS) were measured before and after instillation in two groups. Pudendal nerve stimulation was introduced in study group and its effect on the bladder pressure measurement parameters was measured. Results Intravesical instillation of PGE2 resulted in decreased bladder capacity and increased urination frequency, while there was no change in the area under the curve of bladder contractions/maximum systolic pressure and duration of contractions. Pudendal nerve stimulation reversed the PGE2-induced changes in bladder capacity and increased EMG EUS under specific stimulation condition(1.0 T amplitude at 10 Hz). Conclusion Changes in bladder capacity are mediated by PGE2, and urodynamic changes reported in conscious rats are also observed under urethane anesthesia, and pudendal nerve stimulation is expected to be a novel approach to the treatment of OAB symptoms.