The Feasibility Study Of Bone Marrow Mesenchymal Stem Cells Improving Bladder Dysfunction After Bilateral Pelvic Nerve Injury In Male Rats

Objective: To investigate whether the multi-point injection of homologous bone marrow mesenchymal stem cells(BMSCs)into the bladder wall directly can improve voiding dysfunction induced by bilateral pelvic nerve crush(BPNC)in male rats.Methods: A total of thirty 4-week male Sprague-Dawley rats were randomly divided into 3 groups:(1)Sham-operated(sham,n=10),(2)intra-bladder wall injection of PBS after bilateral pelvic nerve crush(BPNC+PBS,n=10),and(3)intra-bladder wall injection of BMSCs after bilateral pelvic nerve crush(BPNC+BMSCs,n=10).Four weeks postoperatively,functional and morphological examinations were performed.Results: Compared to the sham group,BPNC rats manifested significant augment in frequency of non-voiding contractions,post-void residual and bladder capacity,decreases in intravesical pressure and voiding efficiency,but markedly improved after BMSCs injection.Masson’s staining revealed that the ratio of collagen area in bladder wall tissue significantly increased in BPNC+PBS group,but reduced following BMSCs injection.BPNC could increase the protein expression of TGF-β1、Smad2/3,collagen I/III but decrease the expression of α-SMA.The BMSCs injection stimulated higher expression levels of α-SMA and lower expression levels of the other target proteins.Immunofluorescence showed that BMSCs could differentiate into smooth muscle cells in the bladder wall and the injection of BMSCs boosted the expression quantity of vesicular acetylcholine transporter.Conclusion: BMSCs therapy could suppress detrusor fibrosis,improve detrusor contractility,and partially restore voiding function in male rats after bilateral pelvic nerve crush.