Electrophysiological function during voiding after simulated childbirth injuries.
Electrophysiological function during voiding after simulated childbirth injuries.
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DOI：
10.1016/j.expneurol.2008.10.024
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发表时间：
2009-02
影响因子：
5.3
通讯作者：
Damaser, Margot S.
中科院分区：
文献类型：
--
作者：
Jiang, Hai-Hong;Gustilo-Ashby, A. Marcus;Salcedo, Levilester B.;Pan, Hui Q.;Sypert, David F.;Butler, Robert S.;Damaser, Margot S.
在阴道分娩期间，阴部神经和外尿道括约肌的双重损伤，以及其他损伤，与随后发生的压力性尿失禁有关。目前尚不清楚这些损伤的组合如何影响排尿反射的神经肌肉恢复。分别于伤后4天、3周、6周观察阴道扩张(VD)、阴部神经挤压(PNC)、PNC+VD(PNC+VD)、阴部神经切断(PNT)等排尿时的EUS肌电(EMG)和阴部神经运动支电位(PNMBP)。切除阴部神经和尿路标本，进行组织学研究。在所有损伤后4天和PNC+VD后3周的排尿期，EUS肌电未记录到爆发活动。爆发活动在VD或PNC后3周和PNC+VD后6周恢复，但恢复的爆发内频率仍显著低于对照组。PNMBP的爆发结果与EMG相似，但在VD4天后PNMBP出现爆发，而PNC和PNC+VD后恢复的爆发频率明显高于对照组。PNT术后6周EUS和阴部神经均未恢复。我们的研究结果表明，PNC+VD后排尿时爆发放电的恢复比单独PNC或VD后要慢。这在组织学上在尿路和阴部神经中得到了证实，这可能解释了为什么阴部神经功能障碍在阴道分娩数年后才被观察到。
During vaginal delivery dual injuries of the pudendal nerve and the external urethral sphincter (EUS), along with other injuries, are correlated with later development of stress urinary incontinence. It is not known how combinations of these injuries affect neuromuscular recovery of the micturition reflex. We investigated the EUS electromyogram (EMG) and the pudendal nerve motor branch potentials (PNMBP) during voiding 4 days, 3 weeks or 6 weeks after injury; including vaginal distension (VD), pudendal nerve crush (PNC), both PNC and VD (PNC+VD), and pudendal nerve transection (PNT); and in controls. Pudendal nerve and urethral specimens were excised and studied histologically. No bursting activity was recorded in the EUS EMG during voiding 4 days after all injuries, as well as 3 weeks after PNC+VD. Bursting activity demonstrated recovery 3 weeks after either VD or PNC and 6 weeks after PNC+VD, but the recovered intraburst frequency remained significantly decreased compared to controls. Bursting results of PNMBP were similar to the EMG, except bursting in PNMBP 4 days after VD and the recovered intraburst frequency was significantly increased compared to controls after PNC and PNC+VD. After PNT, neither the EUS nor the pudendal nerve recovered by 6 weeks after injury. Our findings indicate bursting discharge during voiding recovers more slowly after PNC+VD than after either PNC or VD alone. This was confirmed histologically in the urethra and the pudendal nerve and may explain why pudendal nerve dysfunction has been observed years after vaginal delivery.
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DOI：
10.1152/ajprenal.00176.2007
发表时间：
2007-11-01
影响因子：
4.2
作者：
Damaser, Margot S.;Samplaski, Mary K.;Kerns, James M.
通讯作者：
Kerns, James M.
DOI：
10.1016/0165-1838(89)90130-6
发表时间：
1989-06-01
期刊：
JOURNAL OF THE AUTONOMIC NERVOUS SYSTEM
影响因子：
--
作者：
MCKENNA, KE;NADELHAFT, I
通讯作者：
NADELHAFT, I
影响因子：
2.9
作者：
PACHECO, P;MARTINEZGOMEZ, M;KOMISARUK, BR
通讯作者：
KOMISARUK, BR
影响因子：
2.9
作者：
PETERS, LC;KRISTAL, MB;KOMISARUK, BR
通讯作者：
KOMISARUK, BR
DOI：
10.1152/ajpregu.00784.2006
发表时间：
2007-04-01
影响因子：
2.8
作者：
Pan, H. Q.;Kerns, J. M.;Damaser, M. S.
通讯作者：
Damaser, M. S.