Functional improvement in spinal cord injury-induced neurogenic bladder by bladder augmentation using bladder acellular matrix graft in the rat
Functional improvement in spinal cord injury-induced neurogenic bladder by bladder augmentation using bladder acellular matrix graft in the rat
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DOI：
10.1007/s00345-006-0142-7
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发表时间：
2007-04-01
影响因子：
3.4
通讯作者：
Dahiya, Rajvir
中科院分区：
文献类型：
--
作者：
Urakami, Shinji;Shiina, Hiroaki;Dahiya, Rajvir
脊髓吻侧至腰骶水平损伤引起膀胱反射亢进和逼尿肌-括约肌协同功能障碍（DSD），并伴有膀胱肥大。我们假设使用膀胱脱细胞基质移植（BAMG）可以改善sci介导的神经源性膀胱的功能。在雌性大鼠（n = 35）中，脊髓损伤是通过横断胸下段脊髓诱导的。脊髓化8周后，在肥厚性膀胱半胱切除术后使用BAMG进行膀胱增强。脊柱化后8周和隆胸后8周进行膀胱造影。测量若干尿动力学参数，并对移植膀胱进行组织学评价。31只大鼠脊髓化8周后存活。22只（71%）大鼠出现膀胱反射性亢进，9只（29%）大鼠膀胱活动不足。26只大鼠存活至8周。尿动力学参数显示增强术后高反射性膀胱和低活动膀胱的某些膀胱功能有所改善。此外，膀胱顺应性在高反射性膀胱中增加，在低反射性膀胱中降低。膀胱增强术降低了大鼠的膀胱容量，而增加了小鼠的膀胱容量。组织学评估显示，sci诱导的神经源性膀胱在增强后8周完全再生BAMG。这是第一次有报道表明sci诱导的神经源性膀胱可以通过BAMG增强来改善排尿功能。排尿功能的改善伴随着BAMG的组织学再生。
Spinal cord injury (SCI) rostral to the lumbosacral level causes bladder hyperreflexia and detrusor-sphincter dyssynergia (DSD), which are accompanied by bladder hypertrophy. We hypothesize that bladder augmentation using a bladder acellular matrix graft (BAMG) can improve the function of SCI-mediated neurogenic bladder. In female rats (n = 35), SCI was induced by transection of the spinal cord at the lower thoracic level. Eight weeks following spinalization, bladder augmentation using BAMG was performed after hemicystectomy of the hypertrophic bladder. Cystometrography was performed at 8 weeks after spinalization and again at 8 weeks after augmentation. Several urodynamic parameters were measured and the grafted bladder was histologically evaluated. Thirty one rats were alive 8 weeks after spinalization. Twenty two (71%) rats developed hyperreflexic bladders and nine (29%) rats had underactive bladders before bladder augmentation. Twenty six rats survived until 8 weeks after augmentation. Urodynamic parameters showed improvement in some bladder functions in both hyperreflexic and underactive bladders after augmentation. In addition, bladder compliance was increased in hyperreflexic bladders and decreased in underactive bladders. Bladder augmentation decreased bladder capacity in high-capacity rats and increased it in low-capacity rats. Histological evaluation showed complete regeneration of BAMG in SCI-induced neurogenic bladder at 8 weeks after augmentation. This is the first report suggesting that the voiding function in SCI-induced neurogenic bladder can be improved by augmentation using BAMG. Improved voiding function was accompanied by histological regeneration of BAMG.