Mp03-19 Investigating the Impact of Pudendal Nerve Injury in a Male Rat Model: Understanding Post-Prostatectomy Stress Urinary Incontinence

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence (MP03)1 May 2024MP03-19 INVESTIGATING THE IMPACT OF PUDENDAL NERVE INJURY IN A MALE RAT MODEL: UNDERSTANDING POST-PROSTATECTOMY STRESS URINARY INCONTINENCE Shaimaa Maher, Daniel Gerber, Tejasvini Malakalapalli, Brett Hanzlicek, Mei Kuang, Lan Wang, and Margot Damaser Shaimaa MaherShaimaa Maher , Daniel GerberDaniel Gerber , Tejasvini MalakalapalliTejasvini Malakalapalli , Brett HanzlicekBrett Hanzlicek , Mei KuangMei Kuang , Lan WangLan Wang , and Margot DamaserMargot Damaser View All Author Informationhttps://doi.org/10.1097/01.JU.0001009488.55564.85.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostatectomy can result in urinary incontinence as the surgery may disrupt key anatomical structures responsible for continence. This study aimed to investigate how pudendal nerve injury affects male continence and establish an innovative male rat model of stress incontinence. METHODS: To assess the acute effects of pudendal nerve exposure and injury, 6 male rats underwent acute testing of leak point pressure (LPP) and external urethral sphincter electromyography (EUS EMG) with an: intact urethra, exposed urethra (UE), exposed pudendal nerve (NE), and after pudendal nerve transection (PNT). To test the chronic effects of pudendal nerve injury, 67 male rats were subjected to pudendal nerve crush (PNC), PNT, or sham pudendal nerve injury. They were then tested for LPP and EUS EMG 4 days, 3 weeks, or 6 weeks after the injury. The urethras were examined histologically following dissection. RESULTS: Following acute PNT, LPP was 35.0±3.8 cm H2O, significantly decreased compared to the NE (61.9±6.6 cm H2O), UE (57.7±4.7 cm H2O), and Intact groups (57.8±4.8 cm H2O). Change in EUS EMG amplitude with LPP testing after acute PNT (2.2±1.0 μV) was significantly decreased compared to the UE group (14.7±4.0 μV). Change in EUS EMG firing rate with LPP testing (215.1±37.8 Hz) after PNT was significantly reduced compared to the NE (521.6±57.4 Hz) and UE groups (562.9±41.35 Hz). Four days after PNC, LPP (42.0±3.3 cm H2O) as well as EUS EMG amplitude (5.0±1.3 μV) and firing rate (563.3±56.4 Hz) were significantly decreased compared to sham (53.5±3.7 cm H2O; 15.88±3 μV; 756.3±38.12 Hz). Three weeks after PNC, LPP (47.2±3.5 cm H2O) and EUS EMG firing rate (591.2±49.1 Hz) were significantly decreased compared to sham (61.9±3.8 cm H2O; 790.9±64.6 Hz). Six weeks after PNC (46.9±3.1 cm H2O; 637.8±35.2 Hz) or PNT (36.7±2.1 cm H2O; 472.7±60.9 Hz), LPP and EMG firing rate remained significantly decreased compared to sham (58.9±3.5 cm H2O; 825.1±43.2 Hz), as did EMG firing rate. EMG amplitude was also significantly decreased after PNC (12.9±2.6 μV) or PNT (4.6±0.9 μV) compared to sham (22.2±1.7 μV). EMG amplitude 6 weeks after PNC was also significantly higher than after PNT. Neuromuscular junctions in the EUS were less well innervated at all time points after PNC compared to sham rats. Collagen infiltration was significantly increased in both PNC and PNT groups with atrophied muscle tissue and higher interstitial space compared to the sham group. CONCLUSIONS: The pudendal nerve plays a significant role in male rat urinary continence. This rat model could facilitate preclinical testing of therapies aimed at improving post-prostatectomy incontinence. Source of Funding: This research Project was supported by a grant from The Cleveland Clinic Research Program Committee RPC IF110222 © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e30 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Shaimaa Maher More articles by this author Daniel Gerber More articles by this author Tejasvini Malakalapalli More articles by this author Brett Hanzlicek More articles by this author Mei Kuang More articles by this author Lan Wang More articles by this author Margot Damaser More articles by this author Expand All Advertisement PDF downloadLoading ...