Increased duration of simulated childbirth injuries results in increased time to recovery
Increased duration of simulated childbirth injuries results in increased time to recovery
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DOI：
10.1152/ajpregu.00784.2006
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发表时间：
2007-04-01
影响因子：
2.8
通讯作者：
Damaser, M. S.
中科院分区：
文献类型：
--
作者：
Pan, H. Q.;Kerns, J. M.;Damaser, M. S.
压力性尿失禁（SUI）的发展与阴道分娩密切相关，特别是第二产程持续时间的增加。然而，骨盆底损伤导致SUI的机制在很大程度上是未知的。本研究的目的是确定阴道扩张（VD）持续时间增加对排尿膀胱测压、漏尿点压力测试和组织学的影响。69处女雌性大鼠进行VD与膨胀的球囊为1或4小时，而33个年龄匹配的大鼠假VD控制。清醒膀胱测压，漏尿点压力测试，和组织病理学测定VD后4天，10天，6周。在两个扩张组中，扩张4天后，泄漏点压力测试期间腹压至泄漏（LPP）的增加显著降低，表明短期尿道阻力降低。VD后10天，LPP在4小时扩张组而不是1小时扩张组中显著降低，这表明在较长的扩张持续时间后需要较长的恢复时间。VD后6周，LPP与假VD值无显著差异，表明尿道阻力恢复正常。相比之下，6周后VD的持续时间，膨胀大鼠没有经历相同的增加排尿量假VD组，这表明VD的一些影响不解决6周内。两个VD组均表现出急性损伤和组织重塑的组织病理学证据。总之，本实验表明压力诱导的缺氧是阴道分娩损伤的可能机制。
Stress urinary incontinence ( SUI) development is strongly correlated with vaginal childbirth, particularly increased duration of the second stage of labor. However, the mechanisms of pelvic floor injury leading to SUI are largely unknown. The aim of this study was to determine the effects of increased duration of vaginal distension (VD) on voiding cystometry, leak point pressure testing, and histology. Sixty-nine virgin female rats underwent VD with an inflated balloon for either 1 or 4 h, while 33 age-matched rats were sham-VD controls. Conscious cystometry, leak point pressure testing, and histopathology were determined 4 days, 10 days, and 6 wk after VD. The increase in abdominal pressure to leakage (LPP) during leak point pressure testing was significantly decreased in both distension groups 4 days after distension, indicative of short-term decreased urethral resistance. Ten days after VD, LPP was significantly decreased in the 4-h but not the 1-h distension group, indicating that a longer recovery time is needed after longer distension duration. Six weeks after VD, LPP was not significantly different from sham-VD values, indicating a return toward normal urethral resistance. In contrast, 6 wk after VD of either duration, the distended rats had not undergone the same increase in voided volume as the sham-VD group, suggesting that some effects of VD do not resolve within 6 wk. Both VD groups demonstrated histopathological evidence of acute injuries and tissue remodeling. In conclusion, this experiment suggests pressure-induced hypoxia as a possible mechanism of injury in vaginal delivery.