摘要
目的观察由内向外经闭孔阴道无张力吊带术（TVT-0）治疗大鼠女性压力性尿失禁（SUI）模型的长期疗效和研究吊带对膀胱尿道结构功能的影响。方法健康雌性sD大鼠24只，随机分为4组。对照组只游离阴部神经，但不切断；其余三组行双侧阴部神经切断术；假手术组按照TVT-O术操作，但不置入吊带；TVT-0组行标准的TVT-O术。于术后6周，行腹压漏尿点压（ALPP）测定和膀胱测压，取中段尿道、膀胱和双侧肾脏进行组织学检查。结果SUI组ALPP较对照组显著下降（P=0．028），TVT-O使ALPP恢复到对照组水平（P=0．686），各组最大逼尿肌收缩压（MP-det）比较差异无统计学意义（x=^2．204，P=0．531），TVT-O组的膀胱顺应性和膀胱容量显著增加。组织学检查见SUI组尿道横纹肌明显萎缩变薄，TVT-O组中段尿道和阴道间的胶原含量比其余三组显著增加（P=0．043）。各组膀胱壁和上尿路结构无异常改变。结论双侧阴部神经切断术可以建立长期稳定的SUI大鼠模型，TVT-O治疗大鼠SUI安全、长期有效；TVT-O术不影响膀胱的收缩功能，但可以使膀胱容量和顺应性增加。
To observe the long - term efficacy of TVT-O in a rat model of stress urinary incontinence and to re- search for the effect of polypropylene sling on the structures and functions of urethra and bladder. Methods A total of 24 female Sprague - Dawley rats were randomly assigned to one of 4 groups, namely normal control, SUI plus TVT-O, SUI plus sham sling and SUI only. SUI was created in the latter 3 groups by bilateral pudendal nerve transection（PNT）, In the sling procedure, a strip of polypropylene mesh was placed at the mid urethral level. Animals in the SUI plus sham sling group were underwent va- ginal dissection only. After 5 weeks ALPP and cystometry measure, histological examination of middle urethra, bladder and bilat- eral kidneys were taken in each rat. Results There is a significant decrease of ALPP in SUI group compared to control group （ P ： 0. 028 ） . TVT-O can recover ALPP to normal value （ p = 0. 686 ）. MPdet has no difference significantly in each group （ X^2=2,204, P=0. 531 ）, The compliance and volume of bladder in TVT-O group significantly increase compared to the other groups, Remarkable athrophy and thining of the urethral striated muscle can be found in SUI group. The amount of collagen between vaginal and middle urethra in TVT-O group increases significantly than the other groups（ P=0. 043 ）. Conclusion Durable and stable rat SUI model can be created by PNT. The treatment of TVT-O for rat SUI model is safe and has a long term efficacy. Polypropylene sling does not affect the bladder contraction, but results in an increase of bladder volume and compliance.
出处
《中原医刊》
2007年第13期6-8,共3页
Central Plains Medical Journal
