title: Neurogenic aspects of stress urinary incontinence.
abstract: OBJECTIVE
  Vaginal childbirth is a significant risk factor for stress urinary incontinence (SUI). Women with SUI demonstrate dysfunction of the pelvic floor and pudendal nerve. Animal models of SUI have been developed to investigate its pathophysiology and for preclinical testing of potential treatments.
  
  
  RESULTS
  Vaginal distension, a method of simulating childbirth injury in animals, produces a reliable decrease in leak point pressure (LPP), a measure of urethral resistance to leakage and quantification of SUI severity in animals. In addition to ischemia and direct tissue damage, vaginal distension causes denervation of the external urethral sphincter (EUS). Pudendal nerve crush produces a similar decrease in LPP, whereas combined PNC and vaginal distension injury delays recovery of LPP compared with either single injury alone. Neurophysiologic studies have elucidated the results of each injury and their combination on pudendal nerve and EUS function. Urethrolysis, electrocautery, and pudendal nerve transection produce more durable functional impairment via both structural damage and denervation. Pubourethral ligament injury eliminates the structural support of the urethra, but its neurologic effects are unknown.
  
  
  CONCLUSIONS
  Animal models demonstrate a complex interplay between tissue damage and pudendal nerve dysfunction, and provide insight into the importance of neuroregeneration in the recovery of continence.
authors: Glickman Urological and Kidney Institute, USA.
authors: Kamran P
authors: KP
authors: Sajadi
authors: Bradley C
authors: BC
authors: Gill
authors: Margot S
authors: MS
authors: Damaser
mesh_terms: D000818:Animals; D002415:Cats; D004195:Disease Models, Animal; D004285:Dogs; D005260:Female; D006801:Humans; D036801:Parturition; D017773:Pelvic Floor / Q000294:innervation; D051381:Rats; D014521:Urethra / Q000293:injuries / Q000294:innervation* / Q000503:physiopathology; D001750:Urinary Bladder, Neurogenic / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000503:physiopathology*