在兔盆底肌张力障碍生存模型中,有害电刺激盆底和阴道可引起短暂性排尿功能障碍

A. Dobberfuhl, Sara Spettel, Catherine Schuler, R. Levin, A. Dubin, E. De
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引用次数: 5

摘要

目的现有资料支持盆底功能障碍与下尿路症状之间的关系。我们建立了兔盆底功能障碍的生存模型,并评估了膀胱测量(CMG)、肌电图(EMG)和动态排尿行为。材料与方法将12只成年雌性处女兔置于代谢笼中,记录其排便和排便情况。在治疗前后进行麻醉CMG/EMG(肌电图),实验组(n=9)接受双侧破伤风针刺激耻骨尾骨肌(PC),对照组(n=3)接受假针置入。7 d后进行经阴道强直刺激和CMG/EMG。5天后进行最后一次CMG/EMG。结果9只接受针刺激的家兔中有7只(78%)出现CMG排尿功能障碍,而经阴道刺激的12只家兔中有6只(50%)出现CMG排尿功能障碍。针刺刺激PC肌导致CMG基底压力、收缩前压力变化、收缩压力、收缩间隔和空隙后残留显著变化;与刺激前相比,第三次收缩时间从38分钟增加到53分钟(p=0.008)。阴道有害刺激导致CMG基础压力和收缩间隔的显著变化;与刺激前相比,第三次收缩时间从37分钟增加到46分钟(p=0.008)。笼参数的变化主要见于直接针刺刺激后。结论:在大多数动物中,强电刺激兔盆底导致排尿改变,提示盆底功能障碍,其特征是膀胱容量增大,收缩间隔时间延长,收缩持续时间延长。
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Noxious electrical stimulation of the pelvic floor and vagina induces transient voiding dysfunction in a rabbit survival model of pelvic floor dystonia
Purpose Existing data supports a relationship between pelvic floor dysfunction and lower urinary tract symptoms. We developed a survival model of pelvic floor dysfunction in the rabbit and evaluated cystometric (CMG), electromyographic (EMG) and ambulatory voiding behavior. Materials and Methods Twelve female adult virgin rabbits were housed in metabolic cages to record voiding and defecation. Anesthetized CMG/EMG was performed before and after treatment animals (n=9) received bilateral tetanizing needle stimulation to the pubococcygeous (PC) muscle and controls (n=3) sham needle placement. After 7 days all animals were subjected to tetanizing transvaginal stimulation and CMG/EMG. After 5 days a final CMG/EMG was performed. Results Of rabbits that underwent needle stimulation 7 of 9 (78%) demonstrated dysfunctional CMG micturition contractions versus 6 of 12 (50%) after transvaginal stimulation. Needle stimulation of the PC musculature resulted in significant changes in: basal CMG pressure, precontraction pressure change, contraction pressure, interval between contractions and postvoid residual; with time to 3rd contraction increased from 38 to 53 minutes (p=0.008 vs. prestimulation). Vaginal noxious stimulation resulted in significant changes in: basal CMG pressure and interval between contractions; with time to 3rd contraction increased from 37 to 46 minutes (p=0.008 vs. prestimulation). Changes in cage parameters were primarily seen after direct needle stimulation. Conclusions In a majority of animals, tetanizing electrical stimulation of the rabbit pelvic floor resulted in voiding changes suggestive of pelvic floor dysfunction as characterized by a larger bladder capacity, longer interval between contractions and prolonged contraction duration.
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