| Background With the advent of a gray society, the incidence of benign prostatic hyperplasia increases gradually in recent years. The majority of patients need operation treatment for symptoms worsening. Bladder spasm is one of common complications after surgery, there are many factors that can cause bladder spasm, rinses inappropriate temperature is one of the main reasons. Observation of the current discussion on the temperature of irrigation fluid at home mainly focused on the clinical cases, both at home and abroad there were experiments about response to temperature changes by in vivo detrusor to explore the experimental study about effects of temperature contraction of isolated detrusor. In this view, we established bladder outlet obstruction model with rat, and irrigated bladder with different temperature to find out the effect of temperature on detrusor function of rats in vivo under the action of neural and humoral factors.Objective This subject aims to observe the effect of temperature on detrusor function of rats in vivo after bladder outlet obstruction through irrigation. Discuss the proper temperature for bladder irrigation. Provide clinical theoretical basis of the proper temperature for bladder irrigation.Methods90healthy female Sprague-Dawley (SD) rats were enrolled in this experiment, and divided into experimental group and control group randomly using the randomizing table method, and70rats were in experimental group,20rats were in control group. Through cystometry was performed in the rats after6weeks of modeling to serve2purposes:1、identified detrusor instability group(DI)and destrusor stability group(DS).2、 estimated the bladder compliance.Then irrigated in vivo rats bladder with different temperature fluid, and the temperature was set by4interval which were A、B、C、D。 Fluid A:4～14℃Fluid B:15～25℃Fluid C:26～30℃Fluid D:31～37℃.The detail experimental method as follows:1. the model of bladder outlet obstruction (BOO) BOO aninmal model was established by inserted1mm epidural anaesthesia catheter into rats bladder after anesthesia with1%pentobarbital sodium, and then partial ligation of the perineal-urethra by4-0silk thread as experimental group. The epidural anaesthesia catheter can be pulled out easily as a degree. Anaesthesia and operation were the same as experimental group,except for not being ligated the urethral canal for the control group.2. Filling cystometry Took out the suture and then inserted lmm epidural anaesthesia catheter into rats bladder of experimental group for cystometry after anesthesia with20%urethane.Filling velocity12ml/h,stopped the infusion when found perfusion liquid flowing out from urethral mouth,recorded the bladder leakage point pressure and bladder capacity.3. In vivo bladder irrigation Irrigated bladder with fluid in different temperature(A、B、 C、D), then recorded the minimum tensile stress which eliciting the detrusor contract. Then fixed adjustment nut, recorded the frequency and amplitude after detrusor contracted stability.4. Stain Took rats bladder and weighed its wet weight, then fixed them in10%paraformaldehyde liquid, ladder dehydration, transparent, paraffin, paraffin embedding, sectioning, HE and Masson, toluidine blue staining.Results1. Conditions of BOO model:successfully establishing stable bladder outlet obstruction model,62rats survived in the process of BOO. The cystometry showed that48rats of DI group,14rats DS group and all of the20rats of control group survived; Studies showed that53rats high compliance and9rats low compliance. Bladder wet weight and capacity of DI group、DS group compared with control group have statistically significance (P<0.05), Bladder wet weight and capacity of DI group、DS group compared with control group are significantly increased.2. The effect of temperature on detrusor function of rats in vivo(1) The minimum tensile stress which can induce the spontaneous contraction waves:the minimum tensile stress which eliciting the spontaneous contraction waves in different temperature was different. In fluid D was minimum, and in fluid A was maximum.The minimum tensile stress which eliciting the spontaneous contraction waves in the same temperature had statistically significance (P<0.05) among different groups, DI group was minimum, and control group was maximum,(2) Contractile traits of detrusor muscle:In vivo detrusor muscle had spontaneous contraction wave, and its frequency and amplitude had statistically significance relationship in different temperature (P<0.05).The amplitude in fluid C was lowest, and in fluid A was highest. The frequency in fluid B was slowest, and in fluid D was highest, the frequency had no statistically significance between fluid B and fluid C(P>0.05).While in the same temperature, frequency and amplitude had statistically significance (P<0.05) among DI group、DS group and control group, control group was higher than experimental group and DI group was much higher than DS group.3. StainBladder staining shows that:(1) HE staining found that detrusor cells incontrol group arranged in neat rows. Muscle bundle of DS group got bulky and cells had irregular arrangement. The same situation occured in DI group also became wide, and got more severe.(2) Masson staining found that muscle fibres in control group arranged in neat rows and there was little collagen fiber. The space of DS group became wider and there were collagen fiber between them. The space in DI group became wide than DS group and rich in collagenous fibers.(3) Mast cells were found in every group through toluidine blue staining. The distribution of Mast cells in control group and DS group was dispersal, and distribution centralism in DI group.Conclusions(1) Under the temperature of26～30℃, contractile frequency decreased and amplitude are lower. Reduce the incidence of bladder spasm, Thus speculate that this temperature is suitable for bladder irrigation.(2) Under the temperature of4～14℃, detrusor in a continuous contraction state, it shows that this temperature is easy to cause bladder spasm, so this temperature is unfavorable for bladder irrigation.(3) Under the temperature of31～37℃, excitability of detrusor increases, frequency obviously increases. This temperature is easy to cause bladder spasm, so this temperature is unfavorable for bladder irrigation... |
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