Diabetes slows the recovery from urinary incontinence due to simulated childbirth in female rats

Abstract

This study was done to test the hypothesis that simulated vaginal birth by vaginal distension (VD) causes more severe urinary incontinence and slower recovery in diabetic rats. After measuring baseline leak point pressure (LPP) in 16 diabetes mellitus (DM) and 16 age- and weight-matched control (Ct) female Sprague-Dawley rats, these animals underwent either VD or sham VD (sham). Four and ten days after the procedures, LPP and conscious cystometry were assessed. Tissues were then harvested and examined by light microscopy. LPP at baseline was equal among all four groups. Four days after VD, LPP in both VD groups dropped to significantly lower levels than in sham rats (P < 0.001). Moreover, LPP in the DM+VD group was significantly lower than in the Ct+VD group. At 10 days, LPP in the Ct+VD group had recovered to its baseline value, whereas the LPP in the DM+VD group remained significantly reduced. DM rats had larger bladder capacity and longer voiding intervals than Ct rats. Histological findings included more severe damage to the external sphincter striated musculature of the urethra in DM+VD group compared with Ct+VD. In conclusion, these findings suggest that DM causes increased severity and delayed functional recovery from the effects of simulated childbirth.

Morphological changes in the fast vs slow fiber profiles of the urethras of diabetic pregnant rats

“…12,13 DM is related to the accumulation of reactive oxygen species, and tissue ischemia can contribute to the myopathic causes of skeletal muscle dysfunction dependently or independently. [14][15][16] Previously, the relationship between oxidative stress and diabetes in pregnant rats was confirmed by our group in a report by Damasceno et al 17 Increasingly, reports have suggested a potential role for inflammation in the pathogenesis of type 2 DM.…”

“…However, the results of our study should be interpreted with the awareness of the following limitations: rats are quadrupeds; they have tails with associated musculature; their bladders are abdominal and not pelvic organs. 12 It is well established that the functional capacity of a muscle is impaired when its fibers are injured. 26 As the function of a skeletal muscle is determined by its mass and fiber composition, 8 our results provide evidence that, in a translational study, diabetes and pregnancy injure striated muscles and alter their fast and slow fiber compositions in rats.…”

Animal Models of Female Stress Urinary Incontinence

“…44 In a rat model of streptozotocin induced diabetes we induced simulated childbirth injuries using VD and noted that diabetes, which is an independent risk factor for urinary incontinence, increased the severity of SUI beyond that caused by VD alone. Diabetes also delayed recovery from the simulated birth trauma and increased the histological effects of VD.…”

Pesquisa translacional em diabetes melito gestacional e hiperglicemia gestacional leve: conhecimento atual e nossa experiência

“…Os resultados de nossos estudos translacionais assim como de outros pesquisadores mostraram que o diabetes induz alterações na capacidade e complacência, na composição do tecido e parede da bexiga, além de atrofia do músculo estriado uretral e mudanças no perfil das fibras musculares (68,(70)(71)(72). Estudo translacional realizado por Marini e cols.…”