MP08-09 NERVE TRANSFER FOR RESTORATION OF LOWER MOTOR NEURON-LESIONED BLADDER FUNCTION. CORRELATION BETWEEN HISTOLOGICAL CHANGES AND NERVE EVOKED CONTRACTIONS

Abstract

You have accessJournal of UrologyBladder & Urethra: Anatomy, Physiology & Pharmacology (MP08)1 Sep 2021MP08-09 NERVE TRANSFER FOR RESTORATION OF LOWER MOTOR NEURON-LESIONED BLADDER FUNCTION. CORRELATION BETWEEN HISTOLOGICAL CHANGES AND NERVE EVOKED CONTRACTIONS Mary Barbe, Courtney L. Testa, Geneva E. Cruz, Nagat A. Frara, Ekta Tiwari, Lucas J. Hobson, Brian S McIntyre, Danielle S. Porreca, Dania Giaddui, Alan S. Braverman, Emily P. Day, Mamta Amin, Justin M. Brown, Michael Mazzei, Michel A. Pontari, Ida J. Wagner, and Michael R. Ruggieri Mary BarbeMary Barbe More articles by this author , Courtney L. TestaCourtney L. Testa More articles by this author , Geneva E. CruzGeneva E. Cruz More articles by this author , Nagat A. FraraNagat A. Frara More articles by this author , Ekta TiwariEkta Tiwari More articles by this author , Lucas J. HobsonLucas J. Hobson More articles by this author , Brian S McIntyreBrian S McIntyre More articles by this author , Danielle S. PorrecaDanielle S. Porreca More articles by this author , Dania GiadduiDania Giaddui More articles by this author , Alan S. BravermanAlan S. Braverman More articles by this author , Emily P. DayEmily P. Day More articles by this author , Mamta AminMamta Amin More articles by this author , Justin M. BrownJustin M. Brown More articles by this author , Michael MazzeiMichael Mazzei More articles by this author , Michel A. PontariMichel A. Pontari More articles by this author , Ida J. WagnerIda J. Wagner More articles by this author , and Michael R. RuggieriMichael R. Ruggieri More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001981.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Our main objective was to determine the effects of long-term decentralization of 9-13 months and then reinnervation (followed by an 8-12 month post-reinnervation recovery period), versus the effects of 11-21 months of decentralization, on the histology of the urinary bladder, compared to sham/unoperated control animals. Our second objective was to correlate the histological findings with functional findings from ex vivo smooth muscle strip contractions in response to KCl and electric field stimulation, and with in vivo increases in bladder pressure evoked by electrical stimulation of intact pelvic nerves, transferred peripheral nerves and spinal roots. METHODS: Twelve dogs underwent decentralization by bilateral transection of coccygeal and sacral (S) spinal roots, dorsal roots of lumbar (L)7, and hypogastric nerves. Eight were reinnervated 9-13 months post-decentralization with obturator-to-pelvic nerve and sciatic-to-pudendal nerve transfers, then euthanized 8-12 months later; the remainder served as long-term decentralized only animals. Controls included 11 sham-operated and 3 unoperated animals. Before euthanasia, pelvic or transferred nerves and L1-S3 spinal roots were stimulated and maximum detrusor pressure (MDP) recorded. Bladder specimens were collected for histological and ex vivo smooth muscle contractility studies. RESULTS: Decentralized and reinnervated animals showed less urothelium or a denuded urothelium, fewer intramural ganglia, and more inflammation and collagen in the bladder wall, than controls, although percent muscle was maintained. In reinnervated animals, pgp9.5+ axon density was higher, compared to decentralized animals. Ex vivo smooth muscle contractions in response to KCl correlated positively with submucosal inflammation, detrusor muscle thickness and pgp9.5+ axon density. In vivo, decentralized and reinnervated animals showed lower MDP than controls after stimulation of transferred or pelvic nerves and L7-S3 roots. Reinnervated animals showed higher MDP after stimulation of L1-L6 roots, compared to L7-S3 roots. MDP correlated negatively with detrusor collagen and inflammation, and positively with pgp9.5+ axon density and intramural ganglia numbers. CONCLUSIONS: Although percent muscle and some bladder smooth muscle function was maintained in reinnervated animals, perhaps due to the innervation change, enhanced collagen deposition and inflammation were associated with decreased contractile function. Source of Funding: NIH 1R01NS070267 © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e153-e153 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mary Barbe More articles by this author Courtney L. Testa More articles by this author Geneva E. Cruz More articles by this author Nagat A. Frara More articles by this author Ekta Tiwari More articles by this author Lucas J. Hobson More articles by this author Brian S McIntyre More articles by this author Danielle S. Porreca More articles by this author Dania Giaddui More articles by this author Alan S. Braverman More articles by this author Emily P. Day More articles by this author Mamta Amin More articles by this author Justin M. Brown More articles by this author Michael Mazzei More articles by this author Michel A. Pontari More articles by this author Ida J. Wagner More articles by this author Michael R. Ruggieri More articles by this author Expand All Advertisement Loading ...