Experimental Models of Neuropathic Fecal Incontinence: An Animal Model of Childbirth Injury to the Pudendal Nerve and External Anal Sphincter
Experimental Models of Neuropathic Fecal Incontinence: An Animal Model of Childbirth Injury to the Pudendal Nerve and External Anal Sphincter
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DOI：
10.1007/s10350-008-9283-7
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发表时间：
2008-11-01
影响因子：
3.9
通讯作者：
Jones, J. F. X.
中科院分区：
文献类型：
--
作者：
Healy, C. F.;O'Herlihy, C.;Jones, J. F. X.
目的：分娩是大便失禁最常见的原因，阴部神经损伤是分娩损伤的主要组成部分。本研究旨在建立一种急性肛门外括约肌神经支配损伤的动物模型。建立了两种神经病理性损伤模型。双侧直肠下神经夹伤（A组）作为阳性对照。B组（n = 5）模拟分娩时骨盆压迫力。肛门外括约肌功能的定量分析进行了使用肌电图，肛门外括约肌特定的生产力，和体视学计算肛门外括约肌mass.Results：在两组损伤造成显着的肛门外括约肌萎缩（P = 0.002，方差分析）和肌电图证据的神经再支配在一周。比力（mN力/mg质量）未改变。B组肛门外括约肌肌肉质量在四周后恢复。结论：在骨质骨盆内进行球囊扩张导致肛门外括约肌去神经支配，并提供了一个分娩对人类排便机制影响的实验模型。
PURPOSE: Childbirth is the most common cause of fecal incontinence and damage to the pudendal nerve is a major component of childbirth injury. This study was designed to develop an acute animal model of injury to the innervation of the external anal sphincter.METHODS: Forty-eight female virgin wistar rats were studied. Two models of neuropathic injury were developed. Bilateral inferior rectal nerve crush (Group A) acted as a positive control. Prolonged intrapelvic retrouterine balloon inflation (Group B) simulated the pelvic compressive forces of labor. Quantitative analysis of external anal sphincter muscle function was performed by using electromyography, external anal sphincter specific force production, and stereologic calculation of external anal sphincter mass.RESULTS: Injury in both groups caused significant atrophy of the external anal sphincter (P = 0.002, ANOVA) and electromyographic evidence of reinnervation at one week. Specific force (mN force per mg mass) was not altered. External anal sphincter muscle mass recovered after four weeks in Group B.CONCLUSIONS: Balloon dilation within the boney pelvis results in denervation of the external anal sphincter and offers an experimental model of the effects of childbirth on the continence mechanism in humans.