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Hernández-Bonilla C, Zacapa D, Zempoalteca R, Corona-Quintanilla DL, Castelán F, Martínez-Gómez M. Multiparity Reduces Urethral and Vaginal Pressures Following the Bulboglandularis Muscle Stimulation in Rabbits. Reprod Sci 2023; 30:3379-3387. [PMID: 37277687 PMCID: PMC10643308 DOI: 10.1007/s43032-023-01263-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/08/2023] [Indexed: 06/07/2023]
Abstract
Unlike male mammals showing a well-delimited external urethral sphincter, female mammals have urogenital sphincters shaped by muscles like the urethrovaginal sphincter. Childbirth-related injuries affect morphometry and function of urogenital sphincters in women, which frequently underlies pelvic floor disorders, including stress urinary incontinence and pelvic organ prolapse. The bulboglandularis muscle (Bgm) seems to shape a urogenital sphincter in rabbits. We determined herein the effect of multiparity on urethral and vaginal pressures generated by the Bgm stimulation in age-matched nulliparous and multiparous chinchilla-breed rabbits to stimulate the Bgm with trains of ascending frequencies (from 1 to 100 Hz; 4 s duration each). Subsequently, the Bgm was excised, measured in width, and weighed. Significant differences (P ≤ 0.05) were determined with Mann-Whitney U or Student t-tests or repeated measures two-way ANOVA followed by Tukey tests. Spearman's partial coefficients were calculated to investigate the correlation between the highest pressure (urethral or vaginal) and the Bgm width. Multiparity reduced the weight and the width in the Bgm origin and medial regions. Urethral and vaginal pressures increased in response to the electrical stimulation of Bgm with frequencies from 20 to 100 Hz. Multiparas showed significant reductions in both types of pressures. We detected a strong correlation (conditioned by multiparity) between the medial Bgm width and the highest vaginal pressure. Our present findings demonstrate that multiparity impairs the function of Bgm, resulting in diminished urethral and vaginal pressures. Furthermore, the significant narrowness of the Bgm was correlated with the vaginal pressure recorded.
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Affiliation(s)
| | - Diego Zacapa
- Doctorado en Ciencias Biológicas, Universidad Autónoma de Tlaxcala, Tlaxcala, México
| | - René Zempoalteca
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México
| | | | - Francisco Castelán
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México
- Instituto de Investigaciones Biomédicas, Departamento de Biología Celular y Fisiología, Unidad Foránea Tlaxcala, Universidad Nacional Autónoma de México, Tlaxcala, México
| | - Margarita Martínez-Gómez
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México.
- Instituto de Investigaciones Biomédicas, Departamento de Biología Celular y Fisiología, Unidad Foránea Tlaxcala, Universidad Nacional Autónoma de México, Tlaxcala, México.
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2
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Hernandez-Reynoso AG, Rahman FS, Hedden B, Castelán F, Martínez-Gómez M, Zimmern P, Romero-Ortega MI. Secondary urethral sphincter function of the rabbit pelvic and perineal muscles. Front Neurosci 2023; 17:1111884. [PMID: 36875671 PMCID: PMC9978527 DOI: 10.3389/fnins.2023.1111884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/01/2023] [Indexed: 02/18/2023] Open
Abstract
Perineal and pelvic floor muscles play an important role in continence by providing mechanical support to pelvic organs. It is also known that the pubococcygeus muscle (PcM) contracts in the storage phase and is inactive during voiding, while the bulbospongiosus muscle (BsM) is active during the voiding phase. Recent evidence suggested an additional role of these muscles in supporting urethral closure in rabbits. However, the individual role of perineal and pelvic muscles as urethral sphincters is not well-defined. Here we evaluated the individual, sequential and synergistic roles of the PcM and BsM in assisting urethral closure and defined the optimal electrical stimulation parameters that can effectively contract these muscles and increase the urethral pressure (P ura ) in young nulliparous animals (n = 11). Unilateral stimulation of either the BsM or PcM at 40 Hz induced modest increases in average P ura (0.23 ± 0.10 and 0.07 ± 0.04 mmHg, respectively). Investigation on the changes in P ura evoked by stimulation frequencies between 5 and 60 Hz show that sequential contralateral PcM-BsM activation at 40 Hz induced a 2-fold average P ura increase (0.23 ± 0.07 mmHg) compared to that evoked by PcM stimulation. Simultaneous activation of PcM and BsM at 40 Hz also showed an increased average P ura (0.26 ± 0.04 mmHg), with a 2-fold increase in average P ura observed during the unilateral sequential PcM-BsM stimulation at 40 Hz (0.69 ± 0.2 mmHg). Finally, stimulation at 40 Hz of the bulbospongiosus nerve (BsN) induced an approximate 4-fold increase in average P ura (0.87 ± 0.44 mmHg; p < 0.04) compared to that elicited by BsM stimulation, confirming that direct nerve stimulation is more effective. Together, this study shows that in the female rabbit, both perineal and pelvic muscles support of the urethral function during continence, and that unilateral stimulation of the BsN at 40-60 Hz is sufficient to achieve maximal secondary sphincter activity. The results also support the potential clinical value of neuromodulation of pelvic and perineal nerves as bioelectronic therapy for stress urinary incontinence.
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Affiliation(s)
- Ana G Hernandez-Reynoso
- Department of Bioengineering, The University of Texas at Dallas, Richardson, TX, United States
| | - Farial S Rahman
- Department of Biomedical Engineering and Biomedical Sciences, University of Houston, Houston, TX, United States
| | - Brian Hedden
- Department of Bioengineering, The University of Texas at Dallas, Richardson, TX, United States
| | - Francisco Castelán
- Departamento de Biología Celular y Fisiología, Unidad Foránea Tlaxcala, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Tlaxcala, Tlaxcala, Mexico.,Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala City, Mexico
| | - Margarita Martínez-Gómez
- Departamento de Biología Celular y Fisiología, Unidad Foránea Tlaxcala, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Tlaxcala, Tlaxcala, Mexico.,Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala City, Mexico
| | - Philippe Zimmern
- Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Mario I Romero-Ortega
- Department of Biomedical Engineering and Biomedical Sciences, University of Houston, Houston, TX, United States
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3
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Targeted neuromodulation of pelvic floor nerves in aging and multiparous rabbits improves continence. Sci Rep 2021; 11:10615. [PMID: 34011938 PMCID: PMC8136474 DOI: 10.1038/s41598-021-90088-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/30/2021] [Indexed: 02/03/2023] Open
Abstract
Pelvic floor muscle stretch injury during pregnancy and birth is associated with the incidence of stress urinary incontinence (SUI), a condition that affects 30-60% of the female population and is characterized by involuntary urine leakage during physical activity, further exacerbated by aging. Aging and multiparous rabbits suffer pelvic nerve and muscle damage, resulting in alterations in pelvic floor muscular contraction and low urethral pressure, resembling SUI. However, the extent of nerve injury is not fully understood. Here, we used electron microscopy analysis of pelvic and perineal nerves in multiparous rabbits to describe the extent of stretch nerve injury based on axon count, axon size, myelin-to-axon ratio, and elliptical ratio. Compared to young nulliparous controls, mid-age multiparous animals showed an increase in the density of unmyelinated axons and in myelin thickness in both nerves, albeit more significant in the bulbospongiosus nerve. This revealed a partial but sustained damage to these nerves, and the presence of some regenerated axons. Additionally, we tested whether electrical stimulation of the bulbospongiosus nerve would induce muscle contraction and urethral closure. Using a miniature wireless stimulator implanted on this perineal nerve in young nulliparous and middle age multiparous female rabbits, we confirmed that these partially damaged nerves can be acutely depolarized, either at low (2-5 Hz) or medium (10-20 Hz) frequencies, to induce a proportional increase in urethral pressure. Evaluation of micturition volume in the mid-age multiparous animals after perineal nerve stimulation, effectively reversed a baseline deficit, increasing it 2-fold (p = 0.02). These results support the notion that selective neuromodulation of pelvic floor muscles might serve as a potential treatment for SUI.
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Castelán F, Cuevas-Romero E, Martínez-Gómez M. The Expression of Hormone Receptors as a Gateway toward Understanding Endocrine Actions in Female Pelvic Floor Muscles. Endocr Metab Immune Disord Drug Targets 2021; 20:305-320. [PMID: 32216732 DOI: 10.2174/1871530319666191009154751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/06/2019] [Accepted: 07/19/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To provide an overview of the hormone actions and receptors expressed in the female pelvic floor muscles, relevant for understanding the pelvic floor disorders. METHODS We performed a literature review focused on the expression of hormone receptors mainly in the pelvic floor muscles of women and female rats and rabbits. RESULTS The impairment of the pelvic floor muscles can lead to the onset of pelvic floor dysfunctions, including stress urinary incontinence in women. Hormone milieu is associated with the structure and function alterations of pelvic floor muscles, a notion supported by the fact that these muscles express different hormone receptors. Nuclear receptors, such as steroid receptors, are up till now the most investigated. The present review accounts for the limited studies conducted to elucidate the expression of hormone receptors in pelvic floor muscles in females. CONCLUSION Hormone receptor expression is the cornerstone in some hormone-based therapies, which require further detailed studies on the distribution of receptors in particular pelvic floor muscles, as well as their association with muscle effectors, involved in the alterations relevant for understanding pelvic floor disorders.
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Affiliation(s)
- Francisco Castelán
- Department of Cellular Biology and Physiology, Biomedical Research Institute, National Autonomous University of Mexico, Mexico City, Mexico.,Tlaxcala Center for Behavioral Biology, Autonomous University of Tlaxcala, Tlaxcala, Mexico
| | - Estela Cuevas-Romero
- Tlaxcala Center for Behavioral Biology, Autonomous University of Tlaxcala, Tlaxcala, Mexico
| | - Margarita Martínez-Gómez
- Department of Cellular Biology and Physiology, Biomedical Research Institute, National Autonomous University of Mexico, Mexico City, Mexico.,Tlaxcala Center for Behavioral Biology, Autonomous University of Tlaxcala, Tlaxcala, Mexico
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5
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Corona-Quintanilla DL, López-Juárez R, Pacheco P, Romero-Ortega MI, Castelán F, Martínez-Gómez M. Bladder and urethral dysfunction in multiparous and mature rabbits correlates with abnormal activity of pubococcygeus and bulbospongiosus muscles. Neurourol Urodyn 2020; 39:116-124. [PMID: 31578766 PMCID: PMC9271261 DOI: 10.1002/nau.24176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 09/16/2019] [Indexed: 11/11/2023]
Abstract
AIMS To evaluate the combined effect of age and multiparity on the micturition reflex, including pelvic floor muscle activation. METHODS Young and mature nulliparous rabbits were compared to young and mature multiparas (n = 6 per group). Cystometrograms and urethral pressure (UP) were performed while simultaneously recording the electromyogram (EMG) activity of the pubococcygeus and bulbospongiosus muscles to establish their functional correlation to urological function. RESULTS Multiparity and age significantly influence the bladder and UP affecting the voiding efficiency and intercontraction interval. Such interaction also reduced the UP threshold, timing, and duration. Other bladder and urethral variables were predominantly affected only by age. Urodynamic alterations correlated with abnormal patterns or absent EMG activity of the pubococcygeus and bulbospongiosus muscles. CONCLUSIONS The present findings strongly suggest that multiparity and age affects specific pelvic floor muscle reflex activation during micturition, and may contribute to alterations in bladder and urethral function. This data broadens our understanding of the critical role of the appropriate activity of the individual pelvic floor muscles in micturition.
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Affiliation(s)
| | - Rhode López-Juárez
- Doctorado en Ciencias Biológicas, Universidad Autónoma de Tlaxcala, Tlaxcala, México
| | - Pablo Pacheco
- Instituto de Investigaciones Biomédicas, Departamento de Biología Celular y Fisiología, Universidad Nacional Autónoma de México, Ciudad de México, México
- Instituto de Neuroetología, Universidad Veracruzana, Xalapa, Veracruz, México
| | | | - Francisco Castelán
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México
- Instituto de Investigaciones Biomédicas, Departamento de Biología Celular y Fisiología, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Margarita Martínez-Gómez
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México
- Instituto de Investigaciones Biomédicas, Departamento de Biología Celular y Fisiología, Universidad Nacional Autónoma de México, Ciudad de México, México
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6
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Signs of damage in pelvic floor muscles at the end of pregnancy in rabbits. Int Urogynecol J 2019; 30:977-984. [DOI: 10.1007/s00192-019-03872-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 01/08/2019] [Indexed: 11/26/2022]
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Castelán F, López‐García K, Moreno‐Pérez S, Zempoalteca R, Corona‐Quintanilla DL, Romero‐Ortega MI, Jiménez‐Estrada I, Martínez‐Gómez M. Multiparity affects conduction properties of pelvic floor nerves in rabbits. Brain Behav 2018; 8:e01105. [PMID: 30240150 PMCID: PMC6192397 DOI: 10.1002/brb3.1105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 07/27/2018] [Accepted: 07/31/2018] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Women often develop pelvic floor dysfunction due to damage to the pelvic musculature during childbirth; however, the effect on pelvic floor nerves function is less understood. This study used adult rabbits to evaluate the electrophysiological and histological characteristics of the bulbospongiosus (Bsn) and pubococcygeus nerves (Pcn) in multiparity. METHODS Compound nerve action potentials (CNAP) were compared between age-matched nulliparous and multiparous animals and associated to the histological characteristics of myelinated axons from the Bsn and Pcn nerves. The extensor digitorum longus nerve (EDLn) was used as negative control. Data were analyzed with unpaired two-tailed Student's t test or Mann-Whitney U test to determine significant differences between groups. RESULTS The onset and peak latencies, duration, and conduction velocity of the motor fibers in these pelvic nerves were not significantly different between nulliparous and multiparous animals. However, the peak-to-peak amplitude and area of the CNAP in both Bsn and Pcn were reduced in multiparous rabbits. Histology showed a higher percentage of axons with myelin disorganization caused by multiparity in these pelvic nerves. Together, the data indicate a reduction in the number of functional pelvic axons due to multiparity. As expected, no effect of parity was observed in the EDLn controls. CONCLUSIONS Present findings demonstrated that multiparity affects myelination and consequently conduction properties in the small pelvic floor nerves.
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Affiliation(s)
- Francisco Castelán
- Departamento de Biología Celular y Fisiología, Unidad Foránea Tlaxcala, Instituto de Investigaciones BiomédicasUniversidad Nacional Autónoma de MéxicoTlaxcalaMéxico
- Centro Tlaxcala de Biología de la ConductaUniversidad Autónoma de TlaxcalaTlaxcalaMéxico
| | - Kenia López‐García
- Departamento de Biología Celular y Fisiología, Unidad Foránea Tlaxcala, Instituto de Investigaciones BiomédicasUniversidad Nacional Autónoma de MéxicoTlaxcalaMéxico
| | - Suelem Moreno‐Pérez
- Centro Tlaxcala de Biología de la ConductaUniversidad Autónoma de TlaxcalaTlaxcalaMéxico
| | - René Zempoalteca
- Maestría en Ciencias BiológicasUniversidad Autónoma de TlaxcalaTlaxcalaMéxico
| | | | | | - Ismael Jiménez‐Estrada
- Departamento de Fisiología, Biofísica y NeurocienciasCentro de Investigación y de Estudios Avanzados del Instituto Politécnico NacionalCiudad de MéxicoMéxico
| | - Margarita Martínez‐Gómez
- Departamento de Biología Celular y Fisiología, Unidad Foránea Tlaxcala, Instituto de Investigaciones BiomédicasUniversidad Nacional Autónoma de MéxicoTlaxcalaMéxico
- Centro Tlaxcala de Biología de la ConductaUniversidad Autónoma de TlaxcalaTlaxcalaMéxico
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8
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López-Juárez R, Zempoalteca R, Corona-Quintanilla DL, Jiménez-Estrada I, Castelán F, Martínez-Gómez M. Multiparity modifies contractile properties of pelvic muscles affecting the genesis of vaginal pressure in rabbits. Neurourol Urodyn 2017; 37:106-114. [PMID: 28543684 DOI: 10.1002/nau.23305] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 04/20/2017] [Indexed: 01/08/2023]
Abstract
AIMS To characterize the contractile properties of the bulbospongiosus (Bsm), isquiocavernosus (Ism), and pubococcygeus muscles (Pcm), and their involvement in the genesis of vaginal pressure in nulliparous and multiparous rabbits. METHODS Age-matched nulliparous and multiparous rabbits were used to record the isometric contractile responses of each muscle as well as the intravaginal pressure evoked by single square electrical pulses and stimulation trains of ascending frequency. To establish significant differences between groups, two-tail unpaired Student t tests were carried out. The linear correlation between intravaginal pressure and muscle contractile force was analyzed with Pearson correlation tests. For all cases, a P ≤ 0.05 was set as statistically significant. RESULTS Multiparity decreased the contractile force of Bsm and Ism generated by high-frequency stimulation trains. The normalized force of the Pcm increased when evoked at 1, 4, and 10 Hz while this decreased at higher frequencies (20, 50, and 100 Hz). The contraction of both Bsm and Ism raised particularly the pressure on the perineal vagina while that of the Pcm increased the pressure in the pelvic vagina. Such a functional segregation is still present in multiparous rabbits albeit it was modified. CONCLUSIONS Multiparity induces changes in the contractile responses of Bsm, Ism, and Pcm, which alterates the vaginal pressure.
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Affiliation(s)
- Rhode López-Juárez
- Doctorado en Ciencias Biológicas, Universidad Autónoma de Tlaxcala, Tlaxcala, México.,Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México
| | - René Zempoalteca
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México
| | | | - Ismael Jiménez-Estrada
- Departamento de Fisiología, Biofísica y Neurociencias, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Ciudad de México, México
| | - Francisco Castelán
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México.,Instituto de Investigaciones Biomédicas, Departamento de Biología Celular y Fisiología, Unidad Foránea Tlaxcala, Universidad Nacional Autónoma de México, Tlaxcala, México
| | - Margarita Martínez-Gómez
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México.,Instituto de Investigaciones Biomédicas, Departamento de Biología Celular y Fisiología, Unidad Foránea Tlaxcala, Universidad Nacional Autónoma de México, Tlaxcala, México
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9
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López-García K, Mariscal-Tovar S, Serrano-Meneses MA, Castelán F, Martínez-Gómez M, Jiménez-Estrada I. Fiber type composition of pubococcygeus and bulbospongiosus striated muscles is modified by multiparity in the rabbit. Neurourol Urodyn 2016; 36:1456-1463. [DOI: 10.1002/nau.23143] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 09/02/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Kenia López-García
- Departamento Fisiología, Biofísica y Neurociencias; Centro de Investigación y Estudios Avanzados Instituto Politécnico Nacional; México Mexico
- Departamento de Biología Celular y Fisiología, Unidad Periférica Tlaxcala, Instituto de Investigaciones Biomédicas; Universidad Nacional Autónoma de México; Tlaxcala Mexico
| | - Silvia Mariscal-Tovar
- Departamento Fisiología, Biofísica y Neurociencias; Centro de Investigación y Estudios Avanzados Instituto Politécnico Nacional; México Mexico
| | | | - Francisco Castelán
- Departamento de Biología Celular y Fisiología, Unidad Periférica Tlaxcala, Instituto de Investigaciones Biomédicas; Universidad Nacional Autónoma de México; Tlaxcala Mexico
- Centro Tlaxcala de Biología de la Conducta; Universidad Autónoma de Tlaxcala; Tlaxcala Mexico
| | - Margarita Martínez-Gómez
- Departamento de Biología Celular y Fisiología, Unidad Periférica Tlaxcala, Instituto de Investigaciones Biomédicas; Universidad Nacional Autónoma de México; Tlaxcala Mexico
- Centro Tlaxcala de Biología de la Conducta; Universidad Autónoma de Tlaxcala; Tlaxcala Mexico
| | - Ismael Jiménez-Estrada
- Departamento Fisiología, Biofísica y Neurociencias; Centro de Investigación y Estudios Avanzados Instituto Politécnico Nacional; México Mexico
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10
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Dobberfuhl AD, Spettel S, Schuler C, Levin RM, Dubin AH, De EJB. Noxious electrical stimulation of the pelvic floor and vagina induces transient voiding dysfunction in a rabbit survival model of pelvic floor dystonia. Korean J Urol 2015; 56:837-44. [PMID: 26682025 PMCID: PMC4681762 DOI: 10.4111/kju.2015.56.12.837] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 10/21/2015] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Existing data supports a relationship between pelvic floor dysfunction and lower urinary tract symptoms. We developed a survival model of pelvic floor dysfunction in the rabbit and evaluated cystometric (CMG), electromyographic (EMG) and ambulatory voiding behavior. MATERIALS AND METHODS Twelve female adult virgin rabbits were housed in metabolic cages to record voiding and defecation. Anesthetized CMG/EMG was performed before and after treatment animals (n=9) received bilateral tetanizing needle stimulation to the pubococcygeous (PC) muscle and controls (n=3) sham needle placement. After 7 days all animals were subjected to tetanizing transvaginal stimulation and CMG/EMG. After 5 days a final CMG/EMG was performed. RESULTS Of rabbits that underwent needle stimulation 7 of 9 (78%) demonstrated dysfunctional CMG micturition contractions versus 6 of 12 (50%) after transvaginal stimulation. Needle stimulation of the PC musculature resulted in significant changes in: basal CMG pressure, precontraction pressure change, contraction pressure, interval between contractions and postvoid residual; with time to 3rd contraction increased from 38 to 53 minutes (p=0.008 vs. prestimulation). Vaginal noxious stimulation resulted in significant changes in: basal CMG pressure and interval between contractions; with time to 3rd contraction increased from 37 to 46 minutes (p=0.008 vs. prestimulation). Changes in cage parameters were primarily seen after direct needle stimulation. CONCLUSIONS In a majority of animals, tetanizing electrical stimulation of the rabbit pelvic floor resulted in voiding changes suggestive of pelvic floor dysfunction as characterized by a larger bladder capacity, longer interval between contractions and prolonged contraction duration.
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Affiliation(s)
- Amy D Dobberfuhl
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA. ; Division of Urology, Albany Medical College, Albany, NY, USA
| | - Sara Spettel
- Division of Urology, Albany Medical College, Albany, NY, USA
| | | | | | - Andrew H Dubin
- Department of Physical Medicine and Rehabilitation, Albany Medical College, Albany, NY, USA
| | - Elise J B De
- Division of Urology, Albany Medical College, Albany, NY, USA
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11
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López-García K, Cuevas E, Sánchez-García O, Pacheco P, Martínez-Gómez M, Castelán F. Differential damage and repair responses of pubococcygeus and bulbospongiosus muscles in multiparous rabbits. Neurourol Urodyn 2014; 35:180-5. [PMID: 25451605 DOI: 10.1002/nau.22702] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 10/09/2014] [Indexed: 11/08/2022]
Abstract
AIM To determine the extent of damage and regeneration associated with multiparity on the pubococcygeus and bulbospongiosus muscles. METHODS Age-matched virgin nulliparous and multiparous rabbits that were killed at days 3 and 20 after the fourth delivery were used to harvest pubococcygeus and bulbospongiosus muscles. The activity of the lysosomal enzyme β-glucuronidase was used as a muscle damage indicator. The number of immunoreactive myofiber-associated nuclei anti-Pax7, -MyoD, and -myogenin, as well as the anti-desmin immunoreactive area were measured in muscle sections to estimate some regenerative stages. Significant differences were considered at a P ≤ 0.05. RESULTS The β-glucuronidase activity was increased at postpartum day 20 in the pubococcygeus muscle. This variable was unaltered in the bulbospongiosus muscles of multiparas regardless of the postpartum day on which this was measured. The number of immunoreactive nuclei anti-Pax7 in the pubococcygeus muscle was similar between nulliparas and multiparas, whilst those of anti-MyoD and anti-myogenin were increased at postpartum days 3 and 20. The same was true for these latter three markers evaluated in the bulbospongiosus muscles, supporting an ongoing regeneration. The desmin-positive percentage of muscle area per field was increased at postpartum day 20 in the pubococcygeus muscle, whilst such an increment was seen at postpartum days 3 and 20 in the bulbospongiosus muscles. CONCLUSIONS Damage and regeneration of the pubococcygeus and bulbospongiosus muscles are differently influenced by multiparity in rabbits. This could rely on the anatomical location, metabolism, myofiber composition, and muscle exertion during pregnancy and/or the delivery of each muscle.
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Affiliation(s)
- Kenia López-García
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México.,Doctorado en Neuroetología, Universidad Veracruzana, Xalapa, México
| | - Estela Cuevas
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México
| | - Octavio Sánchez-García
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México.,Doctorado en Neuroetología, Universidad Veracruzana, Xalapa, México
| | - Pablo Pacheco
- Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México-DF, México.,Instituto de Neuroetología, Universidad Veracruzana, Xalapa, México
| | - Margarita Martínez-Gómez
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México.,Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México-DF, México
| | - Francisco Castelán
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México
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Xelhuantzi N, Rodríguez-Antolín J, Nicolás L, Castelán F, Cuevas E, Martínez-Gómez M. Tissue alterations in urethral and vaginal walls related to multiparity in rabbits. Anat Rec (Hoboken) 2014; 297:1963-70. [DOI: 10.1002/ar.23006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 07/07/2014] [Accepted: 07/08/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Nicte Xelhuantzi
- Doctorado en Ciencias Naturales; Universidad Autónoma de Tlaxcala; Tlaxcala México
| | - Jorge Rodríguez-Antolín
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala; Tlaxcala México
| | - Leticia Nicolás
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala; Tlaxcala México
| | - Francisco Castelán
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala; Tlaxcala México
| | - Estela Cuevas
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala; Tlaxcala México
| | - Margarita Martínez-Gómez
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala; Tlaxcala México
- Depto. de Biología Celular y Fisiología; Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM); México DF México
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Fiber type characterization of striated muscles related to micturition in female rabbits. Acta Histochem 2014; 116:481-6. [PMID: 24231156 DOI: 10.1016/j.acthis.2013.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 10/06/2013] [Accepted: 10/07/2013] [Indexed: 12/11/2022]
Abstract
Pelvic and perineal striated muscles are relevant for reproduction and micturition in female mammals. Damage to these muscles is associated with pelvic organ prolapse and stress urinary incontinence. The fiber type composition of skeletal muscle influences the susceptibility for damage and/or regeneration. The aim of the present study was to determine the fiber type composition of a perineal muscle, the bulbospongiosus, and a pelvic muscle, the pubococcygeus. Both muscles were harvested from adult female rabbits (8-10 months old). NADH-TR (nicotinamide adenine dinucleotide tetrazolium reductase) histochemistry was undertaken to identify oxidative and glycolytic muscle fibers. Alkaline (pH 9.4) ATP-ase (actomyosin adenosine triphosphatase) histochemistry was used to classify type I, type IIb or type IIa/IId muscle fibers. Results showed that the content of glycolytic fibers in the bulbospongiosus muscle was higher than that of oxidative fibers. Meanwhile, the opposite was true for the pubococcygeus. In the bulbospongiosus muscle, the content of type IIb muscle fibers was higher than that of type I, but was similar to that of type IIa/IId. In contrast, the content of each fiber type was similar in the pubococcygeus muscle. The relative proportion of fibers in bulbospongiosus and pubococcygeus muscles is consistent with their function during voiding and storage phases of micturition.
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Morphometry of paravaginal ganglia from the pelvic plexus: impact of multiparity, primiparity, and pregnancy. Eur J Obstet Gynecol Reprod Biol 2013; 170:286-92. [DOI: 10.1016/j.ejogrb.2013.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 05/25/2013] [Accepted: 07/01/2013] [Indexed: 11/22/2022]
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Effect of multiparity on morphometry and oestrogen receptor expression of pelvic and perineal striated muscles in rabbits: is serum oestradiol relevant? Eur J Obstet Gynecol Reprod Biol 2013; 169:113-20. [PMID: 23664379 DOI: 10.1016/j.ejogrb.2013.03.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Revised: 01/11/2013] [Accepted: 03/25/2013] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To determine changes in morphometry and expression of oestrogen receptors (OR) in the pubococcygeus and bulbospongiosus muscles, and the concentration of serum oestradiol associated with multiparity. STUDY DESIGN Twelve chinchilla-breed female rabbits were divided into multiparas who had undergone four consecutive deliveries and age-matched virgin nulliparas. Pubococcygeus and bulbospongiosus muscles were surgically removed from each rabbit and processed histologically. Fibre cross-sectional area, number of peripheral nuclei, and expression of ORα and ORβ were measured for each muscle. Serum samples were obtained and the concentration of serum oestradiol was quantified. RESULTS Multiparity increased (p ≤ 0.05) fibre cross-sectional area and the number of peripheral nuclei per fibre in pubococcygeus muscle, but not in bulbospongiosus muscle. Expression of both ORα and ORβ was high (p ≤ 0.05) in both muscles from multiparous rabbits. A rise in serum oestradiol was measured at the end of the second pregnancy, which was absent (p ≤ 0.05) at the end of the fourth pregnancy. The concentration of serum oestradiol was similar (p > 0.05) in nulliparous and multiparous rabbits. CONCLUSIONS Multiparity caused morphometric changes in pubococcygeus muscle but not in bulbospongiosus muscle. As OR expression was high for both muscles, some properties related to fibre composition or muscle physiology could be affected. The finding that serum oestradiol was not elevated at the end of the fourth pregnancy could be related to changes in pelvic and perineal muscles associated with multiparity.
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Rajasekaran MR, Sohn D, Salehi M, Bhargava V, Fritsch H, Mittal RK. Role of puborectalis muscle in the genesis of urethral pressure. J Urol 2012; 188:1382-8. [PMID: 22906663 DOI: 10.1016/j.juro.2012.06.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Indexed: 11/28/2022]
Abstract
PURPOSE The internal (smooth muscle) and the external (rhabdosphincter striated muscle) urethral sphincters have important roles in the genesis of urethral closure pressure. The U-shaped pelvic floor puborectalis muscle is important in the closure of anal and vaginal orifices in humans. We defined the contribution of the puborectalis to urethral pressure. MATERIALS AND METHODS A total of 11 female rabbits were anesthetized and prepared to measure urethral, vaginal and anal canal pressure using manometric methods. Pressure was recorded at rest, after administration of pharmacological agents and during electrical stimulation of the puborectalis and rhabdosphincter sphincter muscles. Phenylephrine, sodium nitroprusside (Sigma-Aldrich®) and rocuronium bromide (PharMEDium, Lake Forest, Illinois) were used to define the relative contribution of smooth and striated muscles to urethral pressure. Histology of the pelvic floor hiatus was also studied. RESULTS At rest mean ± SEM maximum urethral pressure was 13 ± 6 mm Hg. Sodium nitroprusside (50 μg/kg) infusion resulted in a 30% to 40% decrease in resting urethral pressure (mean 7.2 ± 0.2 mm Hg). Phenylephrine produced a dose dependent increase in urethral pressure (mean 17 ± 6, 25 ± 5 and 29 ± 6 for 5, 10 and 50 μg/kg intravenously, respectively). Electrical stimulation of the puborectalis muscle induced a stimulus dependent increase in urethral, vaginal and anal canal pressure. On the other hand, rhabdosphincter stimulation induced a stimulus intensity dependent increase in urethral pressure only. The increase in urethral pressure after puborectalis muscle stimulation was more than twofold higher than after rhabdosphincter stimulation. CONCLUSIONS Our data prove that the puborectalis, a component of the pelvic floor muscles, is an important contributor to urethral pressure in the rabbit.
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Affiliation(s)
- M Raj Rajasekaran
- Division of Gastroenterology, Department of Medicine, University of California-San Diego and San Diego Veterans Affairs Healthcare System, San Diego, California 92161, USA
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