1762 EFFECTS OF OBESITY AND TYPE 2 DIABETES ON RECOVERY FROM PUDENDAL NERVE INJURY IN FEMALE ZUCKER RATS

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence - Evaluation & Therapy III1 Apr 20101762 EFFECTS OF OBESITY AND TYPE 2 DIABETES ON RECOVERY FROM PUDENDAL NERVE INJURY IN FEMALE ZUCKER RATS Hai-Hong Jiang, Bradley Gill, Dan Li Lin, Jonathan Glaab, Bruce Kinley, and Margot Damaser Hai-Hong JiangHai-Hong Jiang More articles by this author , Bradley GillBradley Gill More articles by this author , Dan Li LinDan Li Lin More articles by this author , Jonathan GlaabJonathan Glaab More articles by this author , Bruce KinleyBruce Kinley More articles by this author , and Margot DamaserMargot Damaser More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1672AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Along with childbirth, obesity and Type 2 Diabetes (DM) are risk factors for Stress Urinary Incontinence (SUI). Diabetic peripheral neuropathy and pre-diabetes are also associated with SUI. The ongoing obesity epidemic and related increase in DM incidence highlight the value of understanding their effects on SUI after childbirth. Using a rat model, this study investigated the impact of obesity and DM on pudendal nerve (PN) recovery after crush injury. METHODS For 10 weeks, female, leptin-resistant, Zucker Diabetic Fatty (ZDF) rats were given low-fat [N=12] or high-fat [N=6] diets and Zucker Lean (ZL) rats received standard feed [N=11]. ZDF rats naturally become obese and only develop DM when given a high-fat diet. Approximately half of each group then underwent 2 consecutive 30 second bilateral PN crushes. Recovery was assessed 4 weeks later with urinary leak point pressure (LPP), PN electroneurography (ENG), and external urethral sphincter (EUS) electromyography (EMG). Specifically, the bladder was filled and intravesical pressure recorded via a supra-pubic catheter while electrodes recorded PN motor branch and EUS potentials at rest and while the exposed bladder was compressed with a cotton swab to induce leakage. Histology was analyzed in additional rats with the same injuries and diets. RESULTS At injury, ZL rats weighed 210g on average and had a mean blood glucose (BG) of 104mg/dl; obese rats weighed 392g with 114mg/dl BG; and obese+DM rats weighed 388g with 345mg/dl BG. Uninjured obese+DM rats showed significantly lower ENG amplitude at rest and in the bladder-to-EUS guarding response during LPP than uninjured ZL rats. Trends in ENG frequency were similar. Obese rats had significantly impaired PN recovery compared to ZL rats at rest and with guarding during LPP. All uninjured ZDF rats had significantly lower EMG amplitude at rest compared to uninjured ZL rats. EMG amplitude during guarding with LPP and the magnitude of change from rest to guarding was significantly lower in injured obese+DM rats compared to injured ZL rats. Trends in EMG frequency were similar. There were no significant differences in bladder pressures between any groups. Obese rats showed increased EUS fibrosis compared to lean rats. CONCLUSIONS Obesity and Type 2 DM was associated with significantly lower PN activity in uninjured animals and impaired EUS guarding response recovery after PN injury. Obesity alone was associated with lower EUS activity and impaired PN recovery. This suggests obesity may impact sphincter function and nerve recovery, while Type 2 DM may contribute to nerve dysfunction. Cleveland, OH© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e681-e682 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hai-Hong Jiang More articles by this author Bradley Gill More articles by this author Dan Li Lin More articles by this author Jonathan Glaab More articles by this author Bruce Kinley More articles by this author Margot Damaser More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...