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This Article Full Text Full Text (PDF) All Versions of this Article: 292/4/F1229    most recent 00292.2006v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Prantil, R. L. Articles by Vorp, D. A. Search for Related Content PubMed PubMed Citation Articles by Prantil, R. L. Articles by Vorp, D. A.

Ex vivo biomechanical properties of the female urethra in a rat model of birth trauma

Departments of ¹Bioengineering, ²Pharmacology, ³Urology, and ⁴Surgery, and the ⁵McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

Submitted 28 July 2006 ; accepted in final form 22 December 2006

Stress urinary incontinence (SUI) is the involuntary release of urine during sudden increases in abdominal pressures. SUI is common in women after vaginal delivery or pelvic trauma and may alter the biomechanical properties of the urethra. Thus we hypothesize that injury due to vaginal distension (VD) decreases urethral basal tone and passive stiffness. This study aimed to assess the biomechanical properties of the urethra after VD in the baseline state, where basal muscle tone and extracellular matrix (ECM) are present, and in the passive state, where inactive muscle and ECM are present. Female rat urethras were isolated in a rat model of acute SUI induced by simulated birth trauma. Our established ex vivo system was utilized, wherein we applied intraluminal static pressures ranging from 0 to 20 mmHg. Outer diameter was measured via a laser micrometer. Measurements were recorded via computer. Urethral thickness was assessed histologically. Stress-strain responses of the urethra were altered by VD. Quantification of biomechanical parameters indicated that VD decreased baseline stiffness. The passive peak incremental elastic modulus of the distal segment in VD urethras was less than for controls (1.84 ± 0.67 vs. 1.19 ± 0.70 x 10⁶ dyne/cm², respectively; P = 0.016). An increase was noted in passive low-pressure compliance values in proximal VD urethras compared with controls (9.44 ± 2.43 vs. 4.62 ± 0.60 mmHg^–1, respectively; P = 0.04). Biomechanical analyses suggest that VD alters urethral basal tone, proximal urethral compliance, and distal stiffness. Lack of basal smooth muscle tone, in combination with these changes in the proximal and distal urethra, may contribute to SUI induced by VD.

stress urinary incontinence; sphincter; collagen