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Treatment with platelet-rich plasma attenuates proprioceptor abnormalities in a rat model of postpartum stress urinary incontinence

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Abstract

Introduction and hypothesis

Stress urinary incontinence (SUI) is the most prevalent form of urinary incontinence, and vaginal delivery is a major risk factor for developing SUI. We evaluated the hypothesis that applying the autologous platelet rich plasma (PRP) to the pelvic floor muscles via injection affects expression of proprioceptors and improves postpartum stress urinary incontinence (PSUI) in rats.

Methods

Virgin female Sprague-Dawley rats were divided into control (n = 10) and experimental group(n = 20). Vaginal dilation was used to establish PSUI, and the rats in the experimental group were further divided into the PSUI group (n = 10) and PSUI+PRP group (n = 10). Pelvic floor muscles from rats in the PSUI+PRP group were positioned under ultrasound guidance for PRP injection. The morphology and number of pelvic floor muscle spindles were assessed using H&E staining, proprioceptors evaluated by gold chloride staining, and changes in the expression of neurotrophin-3 (NT-3) and skeletal myosin MY-32 determined by immunohistochemistry.

Results

After 28 days,bladder leak point pressure (BLPP) and abdominal leaking-urine point pressure (ALPP) in rats with PSUI were significantly lower than in control animals (P<0.01). Both BLPP and ALPP increased significantly in the PSUI+PRP group (P<0.01). Compared with the control group, muscle spindle morphology and structure in the PSUI and PSUI+PRP groups had different pathological changes,with higher variations in the PSUI group. The positive signals for NT-3/MY-32 expression in control rats were higher than those from PSUI or PSUI+PRP groups, however, the expression for NT-3/MY-32 in PSUI+PRP animals was higher than that seen in the PSUI group (P < 0.01).

Conclusions

PSUI rats have an abnormal expression of pelvic proprioceptors, which affect proprioceptive function, and further the contractibility of pelvic floor muscles. A PRP injection may restore the sensory function of pelvic proprioceptors, thus improving urine leakage in PSUI rats.

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Acknowledgments

We gratefully acknowledge Weijun Cai PhD, the Director of Medical Experimental Center at third Xiangya Hospital, Central South University, for his guidance and assistance of these experiments.

Funding

The authors gratefully acknowledge funding by Natural Science Foundation of Changsha KQ2007036 and Natural Science Foundation of Hunan Province 2021JJ31012 for the conduct of this research.

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Author notes

  1. Jiaojiao Liu and Zhaoxue Liu contributed equally to this work.

Authors and Affiliations

  1. Department of Rehabilitation Medicine, the 3rd Xiangya Hospital, Central South University, Changsha, China

    Jiaojiao Liu, Zhaoxue Liu, Yuan Tang & Xuhong Li

  2. Centro Universitario del Norte, Universidad de Guadalajara, Colotlán, Jalisco, Mexico

    Alvaro Munoz

  3. Department of Biomedical Engineering, University of Houston, Houston, TX, USA

    Yingchun Zhang

Authors
  1. Jiaojiao Liu
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  2. Zhaoxue Liu
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  3. Yuan Tang
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  4. Alvaro Munoz
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  5. Yingchun Zhang
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  6. Xuhong Li
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Contributions

JJ Liu, ZX Liu: Project development,Manuscript writing.

A Munoz,Y Tang: Data collection, Data interpretation.

YC Zhang: Manuscript writing,Statistical analysis.

XH Li: Statistical analysis, critical revision of the manuscript.

Corresponding author

Correspondence to Xuhong Li.

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Liu, J., Liu, Z., Tang, Y. et al. Treatment with platelet-rich plasma attenuates proprioceptor abnormalities in a rat model of postpartum stress urinary incontinence. Int Urogynecol J 33, 2159–2167 (2022). https://doi.org/10.1007/s00192-022-05112-w

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  • DOI: https://doi.org/10.1007/s00192-022-05112-w

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