Pudendal, but not tibial, nerve stimulation modulates vulvar blood perfusion in anesthetized rodents.
Pudendal, but not tibial, nerve stimulation modulates vulvar blood perfusion in anesthetized rodents.
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DOI：
10.1007/s00192-022-05389-x
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发表时间：
2023-07
影响因子：
1.8
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中科院分区：
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临床前研究表明，神经调节可增加阴道血流灌注，但对外阴血流灌注的影响尚不清楚。我们假设阴部和胫骨神经刺激可以引起外阴血流灌注的增加。我们使用雌性Sprague-Dawley大鼠在聚氨酯麻醉下进行非存活手术。我们使用激光散斑对比成像（LSCI）测量了对阴部和胫骨神经刺激20分钟后的会阴血液灌注。在胸段脊柱化和休息一段时间后，我们重复每项刺激试验。我们计算了三个会阴区域（外阴、肛门和大腿内侧）在每个神经靶点和脊髓状况下刺激前、期间和之后的平均血液灌注。我们观察到，在脊髓完整和脊髓化的大鼠阴部神经刺激期间，外阴、肛门和大腿内侧的血液灌注显著增加。胫骨神经刺激对脊髓完整大鼠和去脊髓大鼠的会阴部血流灌注均无影响。这是首次研究LSCI患者外阴血流动力学对神经刺激的反应。本研究表明，阴部神经刺激调节外阴血液灌注，表明阴部神经调节改善生殖器血流的潜力，作为一种治疗女性性功能障碍。这项研究进一步支持了神经调节作为一种治疗女性性唤起障碍的方法。需要在非麻醉的生殖器觉醒障碍动物模型中进行研究，以进一步了解神经控制生殖器血流动力学的机制。
Preclinical studies have shown that neuromodulation can increase vaginal blood perfusion, but the effect on vulvar blood perfusion is unknown. We hypothesized that pudendal and tibial nerve stimulation could evoke an increase in vulvar blood perfusion. We used female Sprague–Dawley rats for non-survival procedures under urethane anesthesia. We measured perineal blood perfusion in response to 20-minute periods of pudendal and tibial nerve stimulation using laser speckle contrast imaging (LSCI). After a thoracic-level spinalization and a rest period, we repeated each stimulation trial. We calculated average blood perfusion before, during, and after stimulation for three perineal regions (vulva, anus, and inner thigh), for each nerve target and spinal cord condition. We observed a significant increase in vulvar, anal, and inner thigh blood perfusion during pudendal nerve stimulation in spinally intact and spinalized rats. Tibial nerve stimulation had no effect on perineal blood perfusion for both spinally intact and spinalized rats. This is the first study to examine vulvar hemodynamics with LSCI in response to nerve stimulation. This study demonstrates that pudendal nerve stimulation modulates vulvar blood perfusion, indicating the potential of pudendal neuromodulation to improve genital blood flow as a treatment for women with sexual dysfunction. This study provides further support for neuromodulation as a treatment for women with sexual arousal disorders. Studies in unanesthetized animal models of genital arousal disorders are needed to obtain further insights into the mechanisms of neural control over genital hemodynamics.