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MODELING THE INFLUENCE OF ACUTE CHANGES IN BLADDER ELASTICITY ON PRESSURE AND WALL TENSION DURING FILLING

机译:模拟填充过程中膀胱弹性的急剧变化对压力和墙体张力的影响

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摘要

Tension-sensitive nerves in the bladder wall are responsible for providing bladder sensation. Bladder wall tension, and therefore nerve output, is a function of bladder pressure, volume, geometry and material properties. The elastic modulus of the bladder is acutely adjustable, and this material property is responsible for adjustable preload tension exhibited in human and rabbit detrusor muscle strips and dynamic elasticity revealed during comparative-fill urodynamics in humans. A finite deformation model of the bladder was previously used to predict filling pressure and wall tension using uniaxial tension test data and the results showed that wall tension can increase significantly during filling with relatively little pressure change. In the present study, published uniaxial rabbit detrusor data were used to quantify regulated changes in the elastic modulus, and the finite deformation model was expanded to illustrate the potential effects of elasticity changes on pressure and wall tension during filling. The model demonstrates a shift between relatively flat pressure-volume filling curves, which is consistent with a recent human urodynamics study, and also predicts that dynamic elasticity would produce significant changes in wall tension during filling. The model results support the conclusion that acute regulation of bladder elasticity could contribute to significant changes in wall tension for a given volume that could lead to urgency, and that a single urodynamic fill may be insufficient to characterize bladder biomechanics. The model illustrates the potential value of quantifying wall tension in addition to pressure during urodynamics.
机译:膀胱壁中紧张敏感的神经负责提供膀胱感觉。膀胱壁张力以及因此的神经输出是膀胱压力,体积,几何形状和材料特性的函数。膀胱的弹性模量是可以急性调节的,这种材料特性决定了在人和兔逼尿肌条中表现出的可调节的预紧张力以及在人体内比较充盈的尿动力学期间表现出的动态弹性。先前使用单轴张力测试数据使用了膀胱的有限变形模型来预测填充压力和壁张力,结果表明,在填充过程中壁张力可以显着增加,而压力变化相对较小。在本研究中,已发表的单轴兔逼尿肌数据用于量化弹性模量的调节变化,并扩展了有限变形模型以说明填充过程中弹性变化对压力和壁张力的潜在影响。该模型演示了相对平坦的压力-体积填充曲线之间的转换,这与最近的人体尿动力学研究一致,并且还预测动态弹性将在填充过程中引起壁张力的显着变化。该模型的结果支持以下结论:对于给定的体积,膀胱弹性的急性调节可能会导致壁张力的显着变化,从而可能导致尿急,并且单个尿动力学填充可能不足以表征膀胱的生物力学。该模型显示了在尿流动力学过程中除压力外还可以量化壁张力的潜在值。

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