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Abstract
Urinary incontinence is a common complication following radical prostatectomy, as the surgery disturbs critical anatomical structures. This study explored how pudendal nerve (PN) injury affects urinary continence in male rats. In an acute study, leak point pressure (LPP) and external urethral sphincter electromyography (EMG) were performed on six male rats with an intact urethra, the urethra exposed (UE), the PN exposed (NE), and after PN transection (PNT). In a chronic study, LPP and EMG were tested in 67 rats 4 days, 3 weeks, or 6 weeks after sham PN injury, PN crush (PNC), or PNT. Urethras were assessed histologically. Acute PNT caused a significant decrease in LPP and EMG amplitude and firing rate compared to other groups. PNC resulted in a significant reduction in LPP and EMG firing rate 4 days, 3 weeks, and 6 weeks later. EMG amplitude was also significantly reduced 4 days and 6 weeks after PNC. Neuromuscular junctions were less organized and less innervated after PNC or PNT at all timepoints compared to sham injured animals. Collagen infiltration was significantly increased after PNC and PNT compared to sham at all timepoints. This rat model could facilitate preclinical testing of neuroregenerative therapies for post-prostatectomy incontinence.
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Details
1 Cleveland Clinic, Department of Biomedical Engineering, Lerner Research Institute, Cleveland, USA (GRID:grid.239578.2) (ISNI:0000 0001 0675 4725)
2 Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, USA (GRID:grid.239578.2) (ISNI:0000 0001 0675 4725)
3 Cleveland Clinic, Department of Biomedical Engineering, Lerner Research Institute, Cleveland, USA (GRID:grid.239578.2) (ISNI:0000 0001 0675 4725); Louis Stokes Cleveland VA Medical Center, Advanced Platform Technology Center, Cleveland, USA (GRID:grid.410349.b) (ISNI:0000 0004 5912 6484)
4 Cleveland Clinic, Department of Biomedical Engineering, Lerner Research Institute, Cleveland, USA (GRID:grid.239578.2) (ISNI:0000 0001 0675 4725); Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, USA (GRID:grid.239578.2) (ISNI:0000 0001 0675 4725); Louis Stokes Cleveland VA Medical Center, Advanced Platform Technology Center, Cleveland, USA (GRID:grid.410349.b) (ISNI:0000 0004 5912 6484)