Effect of vaginal distension on blood flow and hypoxia of urogenital organs of the female rat
Effect of vaginal distension on blood flow and hypoxia of urogenital organs of the female rat
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DOI：
10.1152/japplphysiol.01071.2004
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发表时间：
2005-05-01
影响因子：
3.3
通讯作者：
Levin, RM
中科院分区：
文献类型：
--
作者：
Damaser, MS;Whitbeck, C;Levin, RM
阴道分娩的儿童会导致骨盆底组织的创伤性损伤，并与压力性尿失禁相关;然而，器官和组织损伤导致尿失禁发展的确切机制尚不清楚。本项目的目的是检验以下假设：阴道扩张导致导致泌尿生殖器官血流量减少和缺氧，这可能表明损伤的缺血和/或再灌注机制。13只雌性大鼠阴道扩张1h。13只年龄匹配的大鼠为假扩张对照组。使用微球技术测定膀胱、尿道和阴道的血流量。通过免疫组织化学方法测定这些器官的缺氧情况。在阴道扩张释放之前，所有三个器官的血流量均显着减少。膀胱血流量进一步减少后立即释放阴道扩张，并继续显着减少后15分钟释放。尿道和阴道的血流量在释放后立即增加了两倍，迅速恢复到正常值。阴道扩张导致广泛的平滑肌缺氧的膀胱，以及广泛的缺氧的阴道上皮和尿道缺氧。假扩张大鼠的膀胱表现出尿路上皮缺氧以及逼尿肌的局灶性缺氧区域。我们已经清楚地表明，阴道扩张导致膀胱、尿道和阴道的血流减少和缺氧，支持缺氧损伤作为导致压力性尿失禁的可能损伤机制。
Vaginal delivery of children causes traumatic injury to tissues of the pelvic floor and is correlated with stress urinary incontinence; however, the exact mechanism of organ and tissue injury leading to incontinence development is unknown. The purpose of this project was to test the hypothesis that vaginal distension results in decreased blood flow to, and hypoxia of, the urogenital organs responsible for continence, which would suggest an ischemic and/or reperfusion mechanism of injury. Thirteen female rats underwent vaginal distension for 1 h. Thirteen age-matched rats were sham-distended controls. Blood flow to the bladder, urethra, and vagina were determined using a microsphere technique. Hypoxia of these organs was determined by immunohistochemistry. Blood flow to all three organs was significantly decreased just before release of vaginal distension. Bladder blood flow decreased further immediately after release of vaginal distension and continued to be significantly decreased 15 min after the release. Blood flow to both the urethra and vagina tripled immediately after release, inducing a rapid return to normal values. Vaginal distension resulted in extensive smooth muscle hypoxia of the bladder, as well as extensive hypoxia of the vaginal epithelium and urethral hypoxia. Bladders from sham-distended rats demonstrated urothelial hypoxia as well as focal hypoxic areas of the detrusor muscle. We have clearly demonstrated that vaginal distension results in decreased blood flow to, and hypoxia of, the bladder, urethra, and vagina, supportive of hypoxic injury as a possible mechanism of injury leading to stress urinary incontinence.