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Am J Physiol Renal Physiol 293: F1614-F1621, 2007. First published August 29, 2007; doi:10.1152/ajprenal.00176.2007
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Time course of neuroanatomical and functional recovery after bilateral pudendal nerve injury in female rats

Margot S. Damaser,1,2,3,4 Mary K. Samplaski,1 Mansi Parikh,3,4 Dan Li Lin,1,2,3,4 Soujanya Rao,3,4 and James M. Kerns5

1Cleveland Clinic and 2Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, and 3Hines Veterans Affairs Hospital, Hines; 4Loyola University Stritch School of Medicine, Maywood; and 5Rush University Medical Center, Chicago, Illinois

Submitted 13 April 2007 ; accepted in final form 27 August 2007

The pudendal nerve innervates the external urethral sphincter (EUS) and is among the tissues injured during childbirth, which may lead to symptoms of stress urinary incontinence (SUI). To understand the mechanisms of injury and repair, urethral leak-point pressure (LPP) was measured 4 days, 2 wk, or 6 wk after bilateral pudendal nerve crush. Morphometric changes in the distal nerve and EUS were examined by light and electron microscopy. To determine whether recovery resulted from pudendal neuroregeneration, LPP was measured before and after pudendal nerve transection 2 wk after nerve crush. LPP was significantly decreased 4 days after pudendal nerve crush compared with sham-injured animals as well as 2 or 6 wk after nerve crush. LPP was not significantly different 2 or 6 wk after nerve crush compared with sham-injured animals, suggesting that urethral function had returned to normal. Four days after pudendal nerve crush, the EUS branch of the pudendal nerve distal to the injury site showed evidence of nerve degeneration and the EUS appeared disrupted. Two weeks after nerve crush, the distal nerve and EUS both showed evidence of both nerve degeneration and recovery. Two weeks after nerve crush, LPP was significantly decreased after nerve transection. Six weeks after nerve injury, evidence of neuroregeneration was observed in the pudendal nerve and the EUS. This study has demonstrated that functional recovery and neuroregeneration are significant 2 wk after nerve crush, although by anatomical assessment, recovery appears incomplete, suggesting that 2 wk represents an early time point of initial neuroregeneration.

leak point pressure; urinary incontinence; voiding; pudendal nerve; urethra; Sprague-Dawley


Address for reprint requests and other correspondence: M. S. Damaser, Dept. of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation, 9500 Euclid Ave., ND20, Cleveland, OH 44195






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