压力性尿失禁动物模型的建立

目的 探讨压力性尿失禁(SUI)老鼠模型建立的有效方法,为深入研究SUI的发病机制提供有价值的研究对象.方法 50只Sprague-Dawley大鼠雌雄合笼(合笼比例4∶1),分娩后随机分成两组,即第一组(12只)和第二组(28只).第一组对其常规饲养,不做任何特殊处理.第二组对已育大鼠采用阴道球囊扩张4 h模拟难产,两周后重复一次,常规饲养1个月后切除双侧卵巢.8周后,两部分大鼠均行尿流动力学检查测膀胱最大容量(MBC)和腹部漏尿点压力(ALPP)及喷嚏实验,尿动力学检测完毕后从第二组随机筛选出压力性尿失禁成年已育雌性大鼠模型(12只).结果 对照组和实验组大鼠漏尿点压力值分别为(48.00±1.74)cmH2O和(32.94±1.63)cmH2O,差异有统计学意义(p＜0.05);最大膀胱容量为(2.02±0.19)ml和(1.29±0.16)ml,差异有统计学意义(p＜0.05);喷嚏实验见实验组有13只大鼠表现阳性(阳性率52%),对照组全部阴性.结论 阴道球囊扩张联合双侧卵巢切除可以成功建立压力性尿失禁大鼠模型.     

压力性尿失禁动物模型的建立

Objectives To investigate the effective methods of establishing the rat model of stress urinary incontinence (SUI). Methods 50 Sprague - Dawley rats were caged male and female together (co-cage ratio of 4:1), were randomly divided into two groups after giving birth, the first group (12) and the second group (28). To the first group, we only choose conventional breeding, without any special treatment. The second group we choose female rats after vaginal labour. Their vagina canal was overspread by air ballonet for 4 hours to simulate delivery trauma. Two weeks after the vagina was overspread with the same method again. After another one month ovariectomy was performed on them then conventional breeding for eight weeks, after underwent urodynamic testing maximum bladder capacity (MBC) and abdominal leak point pressure (ALPP) and the sneeze test, after urodynamic testing we randomly choose 12 femal rats stress urinary incontinence (SUI) models from the second group ss for the experimental group(stress urinary incontinence SUI model). Results The modified abdominal leak point pressure of control group and experimental group were (48.00 ± 1.74) cmH2O and (32.94±1.63) cmH2O,the difference was significant (p＜0.05); the maximum cystometries were (2.02±0.19) ml and (1.29±0.16) ml, the difference was significant (p＜0.05); sneeze test, the positive rates of sneeze test of model rat were 13/15(52%), All of the control rats were negative. Conclusions Stress urinary incontinence rats model can be successfully established by vagina balloon dilatation combined with ovariectomy.     

女性压力性尿失禁大鼠模型

压力性尿失禁是女性的常见病，发病率高，致病因素复杂，基础研究薄弱。建立动物模型可为这一疾病的研究提供材料。实验研究可根据模拟人类产伤、雌激素减退、盆底组织去神经化等建立动物模型。各模型的建模依据、建模方法及方法优缺点各有不同，掌握这些不同可为压力性尿失禁大鼠模型的建立提供帮助。     

女性压力性尿失禁

女性压力性尿失禁的诊疗效果一直不够理想，本文综述了这方面的进展，认为注意尿道内括约肌功能的诊断，并针对不同的病因选择不同治疗方法。     

压力性尿失禁的诊治

通过对压力性尿失禁的病因、发病机制的分析,进一步阐明各种术式的优缺点,经闭孔无张力阴道吊带术目前成为最受欢迎的一种术式.     

压力性尿失禁大鼠模型检测的研究现状

压力性尿失禁是泌尿外科常见病，多见于中年女性。其致病因素复杂，相关基础研究薄弱，建立大鼠压力性尿失禁模型可为研究这一疾病提供实验材料，但模型建立成功与否还需进行相关检测。目前对大鼠压力性尿失禁大鼠模型的检测手段有很多，本文着重对功能检测、尿动力学检测、组织学检测、解剖学检测及生化检测等方面进行综述，旨在为压力性尿失禁大鼠模型的研究提供检测方面的理论基础。     

犬压力性尿失禁模型的建立

目的 建立一种雌犬压力性尿失禁(SUI)模型.方法 将9条雌犬随机分为2组,A组4条离断耻骨尿道韧带、切除尿道腹侧及左右侧的纤维结缔组织和脂肪组织,如未出现尿失禁,最终将尿道左右侧、腹侧以及尿道阴道间组织全部切除;B组5条切除尿道阴道间及尿道左右侧的纤维结缔组织和脂肪组织,如未出现尿失禁,再次手术切除尿道左右侧及尿道阴道间因粘连形成的瘢痕组织.结果 A组中3条出现尿失禁,B组全部出现尿失禁.结论 通过切除尿道周围支持组织来建立雌犬压力性尿失禁模型可行,有成功率高、可直接观察等优点.阴道及尿道阴道间组织在尿控上的作用可能比尿道腹侧组织更大.     

压力性尿失禁的外科治疗

通过对压力性尿失禁病理生理的了解,回顾了压力性尿失禁常见术式的演变,有曾经的金标准Burch阴道壁悬吊术,发展到现在创伤和并发症均较小的经闭孔无张力悬吊术（TOT）,成为目前治疗压力性尿失禁的金标准.     

压力性尿失禁治疗方法研究进展

压力性尿失禁(SUI)是女性的一种常见病,严重影响女性生活质量.现行的治疗手段较多,分为非手术治疗和手术治疗方法两类,但疗效不一.近年,SUI治疗获得可喜成果,现综述如下.     

女性压力性尿失禁的外科治疗进展

女性压力性尿失禁的治疗包括注射法、吊带法等，现在注射法、TVT等的适应证已经扩展到各型患者，并且短期效果良好。存在的问题是这些方法的远期疗效尚待评价，进一步改善疗效、减小创伤的外科治疗方法有待研究和开发。     

Comparison of leak point pressure methods in an animal model of stress urinary incontinence

We compared three different methods of testing leak point pressure (LPP) in rats with or without the pudendal nerves and nerves to the iliococcygeus/pubococcygeus muscles transected: (1) sneeze induced with a whisker in the nostril (sneeze LPP), (2) manually increased abdominal pressure (Crede LPP), and (3) increased intravesical pressure using the vertical tilt table method (vertical tilt table LPP). In sham rats, passive intravesical pressure rises in Crede and vertical tilt table methods induced active urethral closure mechanisms that contributed to high LPPs (41.4 and 35.5 cmH₂O, respectively), which were significantly reduced by nerve transection. During sneezing, leakage was observed in nerve-transected rats, but not in sham rats, indicating that sneezing can activate an additional urethral closure mechanism. Measuring LPP during sneezing or passive intravesical pressure rises in the vertical tilt table and Crede method seems to be useful for assessing the continence mechanisms under different stress conditions in rats.     

A grading model for stress urinary incontinence

A classification of stress incontinence is described. The stress test makes it possible to diagnose sphinctero-urethral incompetence and to identify the cases that are objectively negligible. Thus, surgical treatment can be limited to those who require it.     

Management of stress urinary incontinence

Female stress urinary incontinence (SUI) is a common condition with significant impact on a woman’s quality of life. The prevalence of SUI is about 50%. Previously, the majority of incontinence procedures were performed via an abdominal approach (Burch colposuspension). The tension-free procedures, with a synthetic tape material, have replaced almost completely the previous surgeries and is nowadays considered the gold standard option for surgical treatment of female SUI. A wide spectrum of tape-based surgical procedures and devices are currently available. Today, Burch colposuspension has a role in patients undergoing abdominal pelvic organ prolapse (POP) repair as a concomitant procedure in those patients with urethral hypermobility or those with contraindication to mid-urethral slings (MUS) placement. The objective success rate reported of this procedure ranges between 49% and 88%. Mid-urethral synthetic slings represent the most common procedures for SUI in North America and Europe. Cure rate of retropubic MUS approaches 86% with a satisfaction rate of about 75%. For transobturator tape MUS the objective success rate at 12 months is 87% and the satisfaction rate is 85%. Single incision mini-slings (SIMS) were introduced in 2003 and they have a different anchoring mechanism, located at the two extremities, that allows the stabilization of the tape in the obturator internal muscle or deeper in the obturator channel trough a single vaginal incision. Reported objective cure rate is 78% and satisfaction rate is 82%. According to the most recent EAU guidelines about incontinence and the UK National Institute for Healthcare and Clinical Excellence (NICE), the surgeon must be able to offer alternative surgical treatments and have the knowledge of efficacy and safety of these approaches at counseling of the patient. The objective cure rate is rather similar among the different types and routs of mid-urethral slings and the difference vs. Burch colposuspension seems to disappear at 5 years follow-up, when effectiveness is comparable. There is no significant difference in erosion rates between transobturator and retropubic approaches among mid-urethral tapes, but they are lower when compared to SIMS. The injury rate of nearby organs is quite low for all types of approaches, except for retropubic slings.