Pelvic nerve injury negatively impacts female genital blood flow and induces vaginal fibrosis—implications for human nerve‐sparing radical hysterectomy

Abstract

Objective This study sought to develop a novel animal model to study the impact of nerve-sparing radical hysterectomy (NSRH) on female genital blood flow.Design In vivo animal study.Population Thirty Sprague-Dawley female rats.Materials and methods Female rats underwent either unilateral pelvic nerve (PN) crush (PNC; n = 9), or crush of both the PNs and all efferent nerves in the pelvic plexus ('clock-nerve crush', CNC; n = 9). Under anaesthesia, we electrically stimulated the crushed PN at 3 and 10 days after crush while monitoring blood pressure and recording clitoral and vaginal blood flows by laser Doppler. Uninjured PNs were stimulated as an internal control. Twelve additional rats were assigned either to bilateral PNC or sham surgery, and genital tissues were processed 10 days after injury for in vitro analysis. Main outcome measures Genital blood flow, nNOS, eNOS, collagen I-III.Results Stimulation of the crushed PN in both groups subjected to PNC and CNC induced significantly lower peak genital blood flow at 3 and 10 days (P < 0.05) compared to stimulation of the non-crushed control PN. The immunofluorescence and Western blot analyses revealed that all injured rats exhibited more vaginal collagen III and collagen I than rats did that ad undergone sham surgeries (P < 0.05). PCN reduced nNOS expression in both clitoral and vaginal tissue.Conclusions Based on our study it may be hypothesised that NSRH might cause reductions of genital blood flow and vaginal fibrosis due to neurapraxia of the pelvic nerve and reductions of nNOS nerve fibres in clitoral and distal vaginal tissue.

Intratunical injection of stromal vascular fraction prevents fibrosis in a rat model of Peyronie's disease

“…The penile midshaft at the level of the injection site was harvested, fixed, and further processed for histology. Haematoxylin and eosin and Masson's trichrome staining procedures were performed according to a standard protocol, previously described .…”

“…Glyceraldehyde‐3‐phosphate dehydrogenase (GADPH) was used as an internal standard. Primary antibodies were Rb anti‐collagen III (1:1 000; Abcam Inc., Cambridge, MA, USA), Ms anti‐elastin (1:500, Abcam) and Rb controls against GADPH (1:1 000, Santa Cruz Biotechnology, Santa Cruz, CA, USA), Rb anti‐collagen I (1:500; Abcam Inc.) .…”

“…Western blot analysis was performed as previously described [7,22,24,25] for the detection of collagen I, collagen III and elastin proteins at the level of the penile midshafts. Glyceraldehyde-3-phosphate dehydrogenase (GADPH) was used as an internal standard.…”

Is Mode of Delivery Associated With Sexual Response? A Pilot Study of Genital and Subjective Sexual Arousal in Primiparous Women With Vaginal or Cesarean Section Births

“…51,52 Medical interventions that disrupt the APNs (eg, radical hysterectomy and proctolectomy with ileo pouch-anal anastomosis) impair female genital response, manifested as lower vaginal blood flow in response to an erotic film. 13,14,53 In addition, Castiglione et al 54 found impaired genital blood flow in female rats after neuropraxia of the APN (ie, nerve damage caused by a physiological block of nerve conduction within an axon, such as from compression or stretching of the nerve). Therefore, it is plausible that compression of the fetal head during the second stage of labor, which is associated with pudendal nerve damage during childbirth, may also play a role in damage to the APNs.…”

Intratunical injection of autologous adipose stromal vascular fraction reduces collagen III expression in a rat model of chronic penile fibrosis

“…Western blot was performed as previously described [21][22][23] for the detection of collagen I, collagen III, and elastin proteins at the level of the penile midshaft. Glyceraldehyde-3-phosphate dehydrogenase or Beta-Actin were used as an internal standard.…”