title: Perioperative betamethasone treatment reduces signs of bladder dysfunction in a rat model for neurapraxia in female urogenital surgery.
abstract: BACKGROUND
  Information on autonomic neurapraxia in female urogenital surgery is scarce, and a model to study it is not available.
  
  
  OBJECTIVE
  To develop a model to study the impact of autonomic neurapraxia on bladder function in female rats, as well as to assess the effects of corticosteroid therapy on the recovery of bladder function in this model.
  
  
  METHODS
  Female Sprague-Dawley rats were subjected to bilateral pelvic nerve crush (PNC) and perioperatively treated with betamethasone or vehicle. Bladder function and morphology of bladder tissue were evaluated and compared with sham-operated rats.
  
  
  METHODS
  Western blot, immunohistochemistry, organ bath experiments, and cystometry.
  
  
  CONCLUSIONS
  Sham-operated rats exhibited regular micturitions without nonvoiding contractions (NVCs). Crush of all nerve branches of the pelvic plexus or PNC resulted in overflow incontinence and/or NVCs. Betamethasone treatment improved recovery of regular micturitions (87.5% compared with 27% for vehicle; p<0.05), reduced lowest bladder pressure (8 ± 2 cm H(2)O compared with 21 ± 5 cm H(2)O for vehicle; p<0.05), and reduced the amplitude of NVCs but had no effect on NVC frequency in PNC rats. Compared with vehicle, betamethasone-treated PNC rats had less CD68 (a macrophage marker) in the pelvic plexus and bladder tissue. Isolated bladder from betamethasone-treated PNC rats exhibited better nerve-induced contractions, contained more cholinergic and sensory nerves, and expressed lower amounts of collagen III than bladder tissue from vehicle-treated rats.
  
  
  CONCLUSIONS
  PNC causes autonomic neurapraxia and functional and morphologic changes of isolated bladder tissue that can be recorded as bladder dysfunction during awake cystometry in female rats. Perioperative systemic betamethasone treatment reduced macrophage contents of the pelvic plexus and bladder, partially counteracted changes in the bladder tissue, and had protective effects on micturition function.
authors.affiliation: Urological Research Institute, San Raffaele University, Milan, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Castiglione
authors.forename: Alice
authors.initials: A
authors.lastname: Bergamini
authors.forename: Arianna
authors.initials: A
authors.lastname: Bettiga
authors.forename: Trinity J
authors.initials: TJ
authors.lastname: Bivalacqua
authors.forename: Fabio
authors.initials: F
authors.lastname: Benigni
authors.forename: Frank
authors.initials: F
authors.lastname: Strittmatter
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gandaglia
authors.forename: Patrizio
authors.initials: P
authors.lastname: Rigatti
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.forename: Petter
authors.initials: P
authors.lastname: Hedlund
mesh_terms: D000818:Animals; D001342:Autonomic Nervous System Diseases / Q000188:drug therapy* / Q000209:etiology*; D001623:Betamethasone / Q000627:therapeutic use*; D004195:Disease Models, Animal; D005260:Female; D052776:Female Urogenital Diseases / Q000601:surgery*; D005938:Glucocorticoids / Q000627:therapeutic use*; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D007001:Hypogastric Plexus; D019990:Perioperative Care; D051381:Rats; D017207:Rats, Sprague-Dawley; D001745:Urinary Bladder Diseases / Q000188:drug therapy* / Q000209:etiology*; D013520:Urologic Surgical Procedures / Q000009:adverse effects*
chemical_list: D005938:Glucocorticoids; D001623:Betamethasone