Reconstruction of bladder function and prevention of renal deterioration by means of end-to-side neurorrhaphy in rats with neurogenic bladder

To investigate the feasibility of restoring bladder function and prevention of renal deterioration by neurorrhaphy in rats with neurogenic bladder (NB).

Forty-two rats were assigned to the end-to-side nerve coaptation group (ECG, n = 16), no nerve coaptation group (NCG, n = 16), and control group (CG, n = 10). In the ECG, the left ventral root (VR) and dorsal root (DR) of L6 and S1 were transected, and the distal stump of L6VR was sutured to the lateral face of L4VR. In the NCG, the left VR and DR of L6 and S1 were transected, but coaptation was not performed. In the CG, no operation was performed. Nerve regeneration, bladder function, and renal function were evaluated by FluoroGold (FG) retrograde tract tracing, cystometry, electrical stimulation, MRI, histology and biochemical assays.

In the ECG, FG-labeled neurons were observed in the left ventral horn of L4 spinal cord. There was a significant increase in intravesical pressure upon stimulation of the left L4VR proximal to the coaptation. Maximum cystometric capacity, post-void residual urine, bladder compliance and weight, serum creatinine, blood urea nitrogen, and fibrotic area of bladder and kidney were lower in the ECG than in the NCG, but higher than the CG. Hydronephrosis was noticed in ECG and NCG rats. Maximum detrusor voiding pressure was higher in the ECG and CG than in the NCG.

End-to-side neurorrhaphy is a useful method for restoring bladder function and preventing renal injury in rats with NB.

Neurourology and urodynamics. 2017 Nov 21 [Epub ahead of print]

Yun Long Li, Jian Jun Wen, Yi Bo Wen, Xiang Fei He, Jun Wei Wu, Yan Wei Li, Zhong Jiang Han, Jin Jin Feng, Shao Hua Yan, Shou Lin Li, John Pfa Heesakkers, Wan Sheng Gao, Jian Guo Wen

Pediatric Urodynamic Centre, Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China., Emergency Department, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China., Key-Disciplines Laboratory Clinical-Medicine Henan, Zhengzhou, China., Department of Urology, Shenzhen Children's Hospital, Shenzhen, China., Department of Urology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.

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