Abnormalities of somatic peptide-containing nerves supplying the pelvic floor of women with genitourinary prolapse and stress urinary incontinence
Abnormalities of somatic peptide-containing nerves supplying the pelvic floor of women with genitourinary prolapse and stress urinary incontinence
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DOI：
10.1016/j.urology.2003.09.017
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发表时间：
2004-03-01
期刊：
影响因子：
2.1
通讯作者：
De Giorgio, R
中科院分区：
文献类型：
--
作者：
Busacchi, P;Perri, T;De Giorgio, R
目标.为了验证生殖器脱垂可能与周围神经异常有关的假设，我们检测了与脱垂相关的压力性尿失禁女性尿道周围肌肉的含肽神经突起的变化。30名生殖器脱垂患者和10名年龄匹配的对照受试者进入研究。所有患者均行尿动力学检查。30例患者中有10例为单纯压力性尿失禁，对照组无一例尿失禁。在手术过程中，从每名妇女的尿道周围和直肠周围肌肉获得四个活检样本。肌肉切片进行免疫组化处理，使用特异性抗体的神经胶质细胞（S-100蛋白）和一般的神经元标记物（神经元特异性烯醇化酶）和神经肽，包括神经肽Y，血管活性肠多肽，和P物质。免疫标记的神经的评价是基于一个半定量分析，允许一个四点坐标量表scores. Results. The。S-100和神经元特异性烯醇化酶免疫反应阳性神经纤维，单独或小束，沿着含有神经肽Y，血管活性肠多肽和P物质的神经过程的密集网络，发现整个结缔组织和横纹肌的控制标本。与此相反，在泌尿生殖器脱垂的肌肉标本中，神经肽Y、血管活性肠肽和P物质免疫反应神经的密度和强度均明显低于对照组。会阴肌含肽神经供应减少的证据提供了一个形态学基础，表明神经异常有助于生殖器脱垂和尿失禁的发病机制。泌尿学63：591-595，2004年。(C)2004年爱思唯尔公司
Objectives. To test the hypothesis that genital prolapse may be related to peripheral nerve abnormalities, we examined the changes occurring to peptide-containing nerve processes supplying the periurethral muscles in women with stress urinary incontinence associated with prolapse.Methods. Thirty patients with genital prolapse and 10 age-matched control subjects entered the study. All patients were evaluated by urodynamic investigations. Ten of 30 patients had pure stress urinary incontinence; none of the control subjects was incontinent. During surgery, four biopsy samples were obtained from each woman from the periurethral and perirectal muscles. The muscle sections were processed for immunohistochemistry using specific antibodies to glial (S-100 protein) and general neuronal markers (neuron-specific enolase) and neuropeptides, including neuropeptide Y, vasoactive intestinal polypeptide, and substance P. The evaluation of immunolabeled nerves was based on a semiquantitative analysis that allowed for a four-point ordinate scale score.Results. S-100 and neuron-specific enolase immunoreactive nerve fibers, running either singly or in small bundles, along with a dense network of neural processes containing neuropeptide Y, vasoactive intestinal polypeptide, and substance P, were found throughout the connective tissue and striated muscle of the control specimens. In contrast, in the muscle specimens from those with genitourinary prolapse, both the density and the intensity of neuropeptide Y, vasoactive intestinal polypeptide, and substance P immunoreactive nerves were markedly reduced compared with the control specimens.Conclusions. The evidence of a reduced peptide-containing nerve supply to the perineal muscles provides a morphologic basis suggesting that neural abnormalities contribute to the pathogenesis of genital prolapse and urinary incontinence. UROLOGY 63: 591-595, 2004. (C) 2004 Elsevier Inc.