前列腺与会阴盆底联系的电刺激研究

Investigation of relationship between prostate and pelvic floor in rat by electrical stimulation

目的 探讨前列腺炎疼痛产生的神经机理以及疼痛产生与盆底肌功能障碍的关系。 方法 电刺激大鼠前列腺 ,记录腰骶神经反射性动作电位和肛门外括约肌的肌电变化。 结果 电刺激大鼠前列腺后 ,同侧生殖股、髂腹股沟、髂腹下、股外侧皮神经的动作电位阳性率分别为 93 .3 % ,55.5% ,16.6%和 10 .0 % ,潜伏期 4～ 8ms ,波幅 2 0～ 180 μV ;横断颈髓后动作电位下降至 (95.4± 13 .7) % ;动物死亡后动作电位立即消失 ;切除腰骶交感干后动作电位波幅下降至 (2 5.8± 9.7) % ;93 .3 %大鼠在肛门括约肌记录到较为恒定的复合肌肉动作电位 ,潜伏期 (13 .2± 4.7)ms。 结论 前列腺受刺激后可通过脊髓反射经生殖股、髂腹股沟神经等腰骶神经传出 ,引起会阴、盆底肌肉收缩并形成会阴部的牵涉痛。前列腺炎疼痛与神经 盆底肌功能障碍密切相关 。

Objective To elucidate the neurological m ec hanism of the referred pains in pelvic floor from prostate and the relationship between pain from prostate and pelvic floor muscle dysfunction. Meth ods The prostate was electrically stimulated,and the elicited action potentials were recorded from iliohypogastric,ilioinguinal,genitofemoral,latera l femoral cutaneous,femoral,sciatic nerves,and compound muscle action potentials (CMAP) were recorded from anal external sphincter. Results Action potentials were elicited principally in the genitofemoral nerve (93 .3%),ilioinguinal nerve (55.5%);the action potentials of the genitofemoral nerve were not influenced by transaction of the cervical spinal cord,whereas they dis appeared immediately after rat death; the action potentials were reduced conside rably after destruction of the lumbosacral sympathetic trunks.CMAPs were elicite d in the anal external sphincter in 93.3% of the rats (14/15). Conc lusions Electrical stimulation of the prostate induced reflex discha rges in the nerves to perineal,pelvic floor areas.It was postulated that the ref lex discharges are related to muscle contraction leading to referred pain in the perineal,pelvic floor areas.Pain from prostate is correlated significantly with pelvic floor muscle dysfunction.