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J Appl Physiol (December 10, 2004). doi:10.1152/japplphysiol.01071.2004
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Submitted on September 28, 2004
Accepted on December 2, 2004

Effect of Vaginal Distension on Blood Flow and Hypoxia of Urogenital Organs of the Female Rat

Margot S Damaser1, Catherine Whitbeck2, Paul Chichester2, and Robert M Levin3*

1 Research Service, Hines VA Hospital, Hines, IL, USA; Department of Urology, Loyola University Medical Center, Maywood, IL, USA
2 Research Service, Albany VA Medical Center, Albany, NY, USA
3 Research Service, Albany VA Medical Center, Albany, NY, USA; Albany College of Pharmacy, Albany, NY, USA; Department of Urology, Albany Medical College, Albany, NY, USA

* To whom correspondence should be addressed. E-mail: levinr{at}acp.edu.

Vaginal delivery of children causes traumatic injury to tissues of the pelvic floor and is correlated with stress urinary incontinence (SUI); however the exact mechanism of organ and tissue injury leading to incontinence development is unknown. The purpose of this project was to test the hypothesis that vaginal distension results in decreased blood flow to and hypoxia of the urogenital organs responsible for continence, which would suggest an ischemic and/or reperfusion mechanism of injury. Thirteen female rats underwent vaginal distension for 1 hour. Thirteen age-matched rats were sham-distended controls. Blood flow to the bladder, urethra, and vagina were determined using a microsphere technique. Hypoxia of these organs was determined by immunohistochemistry. Blood flow to all 3 organs was significantly decreased just prior to release of vaginal distension. Bladder blood flow decreased further immediately after release of vaginal distension and continued to be significantly decreased 15 minutes after the release. Blood flow to both the urethra and vagina tripled immediately after release, inducing a rapid return to normal values. Vaginal distension resulted in extensive smooth muscle hypoxia of the bladder; as well as extensive hypoxia of the vaginal epithelium and urethral hypoxia. Bladders from sham-distended rats demonstrated urothelial hypoxia as well as focal hypoxic areas of the detrusor muscle. We have clearly demonstrated that vaginal distension results in decreased blood flow to and hypoxia of the bladder, urethra, and vagina, supportive of hypoxic injury as a possible mechanism of injury leading to SUI.




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