压力性尿失禁动物模型的建立及效果评价

背景：目前治疗压力性尿失禁的方法有药物治疗、物理-行为治疗及手术治疗等多种，但仍在探索优化中。 目的：探索通过截断双侧阴部神经及支配髂骨尾骨肌、耻骨尾骨肌的盆底神经肌友，建立稳定的压力性尿失禁动物模型的方法。 方法：6周龄SD雌性大鼠18只，体质量(199.44±8.41) g。随机分为3组，正常组、模型组和假手术组各6只。对模型组大鼠作双侧阴部神经及盆底神经肌支截断，假手术组分离暴露上述神经但不作截断，正常组大鼠不作特殊处理。术后2周测定3组大鼠的漏尿点压力。压力测定后取正常大鼠及模型大鼠的膀胱颈尿道交界部的横截面作组织学分析。 结果与结论：假手术组1只大鼠于术后1周死亡。余大鼠皆存活并顺利测定漏尿点压力。与正常大鼠相比，模型组大鼠平均漏尿点压力下降约33%(P < 0.05)，而假手术组大鼠与正常组大鼠平均漏尿点压力差异无显著性意义(P > 0.05)。组织学检查显示，与正常大鼠比较，模型组大鼠尿道横纹肌排列疏松，而肌纤维也出现一定的萎缩。提示截断双侧阴部神经及盆底神经肌支可建立较为稳定的压力性尿失禁动物模型。

Establishment and evaluation of an animal model of stress urinary incontinence

BACKGROUND: Although drug treatment, physics-behavior therapy, and postoperative therapy have been commonly used to treat stress urinary incontinence (SUI), there is still no satisfactory treatment at present. OBJECTIVE: To build a stable animal model simulating stress urinary incontinence (SUI) by bilateral transaction of pudendal nerve and nerves innervating pelvic floor muscles, including iliococcygeous muscle and pubococcygeous muscle. METHODS: A total of 18 6-week-old female SD rats weighing (199.44±8.41) g were randomly divided into 3 groups: normal, model, and sham-surgery groups, with 6 rats in each group. Rats in the model group underwent bilateral transaction of pudendal nerves and nerves innervating iliococcygeous/pubococcygeous muscles, while rats in the sham-surgery group had same procedures except nerve transaction. The normal group did not undergo any operation. Each rat was subjected to measure leak point pressure (LPP) at 2 weeks after the operation. After the measurement of LPP, cross sections of connection area of bladder and urethra were sent to histology. RESULTS AND CONCLUSION: One rat in the sham-surgery group died at 1 week after the operation. The LPP of model group decreased significantly by approximately 33% compared with the normal group (P < 0.05); however, there was no significant difference in LPP between sham-surgery and normal groups (P > 0.05). The results of histology showed loosely arrangement and atrophy of urethral striated muscle fibers in rats of the model group. Bilateral transaction of pudendal nerves and nerves innervating to iliococcygeous/ pubococcygeous muscles resulted in SUI in rats stably.