Effects of selective autonomic and pudendal denervation on the urethral function and development of retention in female dogs

Effects of selective autonomic and pudendal denervation on the urethral function and development of retention in female dogs
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DOI:
10.1016/s0022-5347(05)65828-4
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发表时间:
2001-10-01
期刊:
影响因子:
6.6
通讯作者:
Ghoneim, MA
Ghoneim, MA
中科院分区:
医学1区
文献类型:
--
作者:
Ali-El-Dein, B;Ghoneim, MA

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目的:本试验旨在探讨女性保留尿道根治性膀胱切除术和原位膀胱置换术后尿失禁和排尿问题的可能原因。材料与方法:1996年1月至1999年1月,选取24只杂种母犬,每期6只。记录尿道自主神经去支配(第1阶段)和膀胱颈远端尿道横断(第2阶段)对尿道压力谱的影响。在第三阶段,我们连续研究了自主神经去支配、尿道横断和去神经横断尿道的药物操作对尿道压力谱的影响。第4期记录阴部神经横断和药物阻断的效果。在12期2和3犬中,将横断的尿道与膀胱颈重新吻合。术后2个月和6个月重复急性实验,行膀胱镜检查,评估空后残余尿量。急性实验6个月后处死2只,行尿道组织病理学检查。结果:自主神经去支配导致第1期和第3期尿道近端平均最大压力下降46%至48% (p
Purpose: This trial is an experimental approach to the possible causes of continence and voiding problems after urethra sparing radical cystectomy and orthotopic bladder substitution in women.Materials and Methods: Between January 1996 and January 1999 we included 24 mongrel female dogs in this 4-phase study of 6 dogs each. The effects of autonomic denervation of the urethra (phase 1) and urethral transection just distal to the bladder neck (phase 2) on the urethral pressure profile were recorded. In phase 3 the effects of autonomic denervation, urethral transection and pharmacological manipulation of the denervated transected urethra on the urethral pressure profile were studied in succession. In phase 4 the effects of pudendal nerve transection and pharmacological blockade were recorded. In the 12 phases 2 and 3 dogs the transected urethra was re-anastomosed to the bladder neck. Acute experiments were repeated after 2 and 6 months, urethrocystoscopy was done and post-void residual urine was estimated. Two of the latter dogs were sacrificed 6 months after the acute experiment and the urethras were histopathologically examined.Results: Autonomic denervation resulted in a 46% to 48% decrease in mean maximal pressure in the proximal urethra in phases 1 and 3 (p