Impairment of accessory nerves around major pelvic ganglion leading to overflow urinary incontinence in rats

Abstract

Aims: To investigate the relationship between lower urinary tract function and the accessory nerve (ACN) arising from the major pelvic ganglion (MPG). Methods: Ten-week-old male Wistar/ST rats were randomly divided into eight groups according to the type of treatment (sham or bilateral accessory nerve injury [BACNI]) and the duration of observation (3 days, 1 week, 2 weeks, or 4 weeks: Sham-3d, Sham-1w, Sham-2w, Sham-4w, BACNI-3d, BACNI-1w, BACNI-2ws, and BACNI-4w. BACNI was induced in the following manner: the ACN was crushed for 1 min (2 mm away from the MPG) using reverse-action tweezers. The same procedure was performed on both sides. On the last day of each observation period, the bladder function was measured by awake cystometry, and histological evaluation was performed. Results: All rats in the Sham groups micturated normally. In the BACNI-3d and BACNI-1w groups, all rats showed symptoms of overflow urinary incontinence (OUI). This OUI improved gradually over time. The bladder's size in the BACNI group was significantly larger than that in the Sham group (p < .01). In addition, fibrosis was observed in the subserosa of the bladder of rats in BACNI groups. Conclusion: The BACNI model rats exhibited OUI, suggesting that ACN is involved in the lower urinary tract function. It might be possible that ACN controls the function of either the bladder, the urethra, or both.

Impact of prostatic radiation therapy on bladder contractility and innervation

“…Another preclinical model of prostatectomy‐induced nerve injury (bilateral cavernous nerve injury) showed increased apoptosis in the adjacent pelvic and hypogastric nerves of the MPG leading to urinary incontinence 23 . Similarly, injury to the rat's MPG accessory nerves also leads to overflow urinary incontinence 24 . A systematic review examined studies with urodynamic measurements in patients before and after radical prostatectomy and found that bladder compliance and contractility were impaired post‐prostatectomy 25 …”

“…23 Similarly, injury to the rat's MPG accessory nerves also leads to overflow urinary incontinence. 24 A systematic review examined studies with urodynamic measurements in patients before and after radical prostatectomy and found that bladder compliance and contractility were impaired post-prostatectomy. 25 The scope of this study was to assess how prostatic RT affects detrusor smooth muscle physiology.…”