Name: evaluating the procedure for performing awake cystometry in a mouse model
Uploaded: 2017-05-20T13:00:00
Description: Watch this Scientific Journal Video about Evaluating the Procedure for Performing Awake Cystometry in a Mouse Model at JoVE.com

This study was funded by the Department of Surgery University of Vermont, Danish Council for Independent Research, and by the Odense University Hospital.

Animals were housed in the University of Vermont Animal Care Facility according to institutional guidelines. All animal experiments were carried out in accordance with the National Institutes of Health guide for the care and use of laboratory animals.
1. Intravesical Tube Implantation
<ol>
	<li>Preparation of tubing and instruments for the surgical procedure
	<ol>
		<li>Cut a 7-cm piece of PE10 tubing to make the catheter for implantation.</li>
		<li>Create a flare at one en...

<ol>
	<li>Perez, L. M., Webster, G. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+History+of+Urodynamics.">The History of Urodynamics.</a> Neurourol Urodyn. 11 (1), 1-21 (1992).</li><li>Fry, C. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Animal+models+and+their+use+in+understanding+lower+urinary+tract+dysfunction.">Animal models and their use in understanding lower urinary tract dysfunction.</a> Neurourol Urodyn. 29 (4), 603-608 (2010).</li><li>Maggi, C. A., Santicioli, P., Meli, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+nonstop+transvesical+cystometrogram+in+urethane-anesthetized+rats:+a+simple+procedure+for+quantitative+studies+on+the+various+phases+of+urinary+bladder+voiding+cycle.">The nonstop transvesical cystometrogram in urethane-anesthetized rats: a simple procedure for quantitative studies on the various phases of urinary bladder voiding cycle.</a> J Pharmacol Methods. 15 (2), 157-167 (1986).</li><li>Malmgren, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cystometrical+evaluation+of+bladder+instability+in+rats+with+infravesical+outflow+obstruction.">Cystometrical evaluation of bladder instability in rats with infravesical outflow obstruction.</a> J Urol. 137 (6), 1291-1294 (1987).</li><li>Pandita, R. K., Fujiwara, M., Alm, P., Andersson, K. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cystometric+evaluation+of+bladder+function+in+non-anesthetized+mice+with+and+without+bladder+outlet+obstruction.">Cystometric evaluation of bladder function in non-anesthetized mice with and without bladder outlet obstruction.</a> J Urol. 164 (4), 1385-1389 (2000).</li><li>Chang, H. Y., Havton, L. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Differential+effects+of+urethane+and+isoflurane+on+external+urethral+sphincter+electromyography+and+cystometry+in+rats.">Differential effects of urethane and isoflurane on external urethral sphincter electromyography and cystometry in rats.</a> Am J Physiol Renal Physiol. 295 (4), F1248-F1253 (2008).</li><li>Matsuura, S., Downie, J. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+anesthetics+on+reflex+micturition+in+the+chronic+cannula-implanted+rat.">Effect of anesthetics on reflex micturition in the chronic cannula-implanted rat.</a> Neurourol Urodyn. 19 (1), 87-99 (2000).</li><li>DePaul, M. A., Lin, C. Y., Silver, J., Lee, Y. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Peripheral+Nerve+Transplantation+Combined+with+Acidic+Fibroblast+Growth+Factor+and+Chondroitinase+Induces+Regeneration+and+Improves+Urinary+Function+in+Complete+Spinal+Cord+Transected+Adult+Mice.">Peripheral Nerve Transplantation Combined with Acidic Fibroblast Growth Factor and Chondroitinase Induces Regeneration and Improves Urinary Function in Complete Spinal Cord Transected Adult Mice.</a> PLoS One. 10 (10), e0139335 (2015).</li><li>Kadekawa, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characterization+of+bladder+and+external+urethral+activity+in+mice+with+or+without+spinal+cord+injury--a+comparison+study+with+rats.">Characterization of bladder and external urethral activity in mice with or without spinal cord injury--a comparison study with rats.</a> Am J Physiol Regul Integr Comp Physiol. 310 (8), R752-R758 (2016).</li><li>Uvin, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+use+of+cystometry+in+small+rodents:+a+study+of+bladder+chemosensation.">The use of cystometry in small rodents: a study of bladder chemosensation.</a> J Vis Exp. (66), (2012).</li><li>Andersson, K. E., Soler, R., Fullhase, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rodent+models+for+urodynamic+investigation.">Rodent models for urodynamic investigation.</a> Neurourol Urodyn. 30 (5), 636-646 (2011).</li><li>Smith, P. P., Kuchel, G. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Continuous+uroflow+cystometry+in+the+urethane-anesthetized+mouse.">Continuous uroflow cystometry in the urethane-anesthetized mouse.</a> Neurourol Urodyn. 29 (7), 1344-1349 (2010).</li><li>Aizawa, N., Homma, Y., Igawa, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Influence+of+High+Fat+Diet+Feeding+for+20+Weeks+on+Lower+Urinary+Tract+Function+in+Mice.">Influence of High Fat Diet Feeding for 20 Weeks on Lower Urinary Tract Function in Mice.</a> Low Urin Tract Symptoms. 5 (2), 101-108 (2013).</li><li>Bjorling, D. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+voiding+assays+in+mice:+impact+of+genetic+strains+and+sex.">Evaluation of voiding assays in mice: impact of genetic strains and sex.</a> Am J Physiol Renal Physiol. 308 (12), F1369-F1378 (2015).</li><li>Morikawa, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+various+drugs+on+bladder+function+in+conscious+rats.">Effects of various drugs on bladder function in conscious rats.</a> Jpn J Pharmacol. 50 (4), 369-376 (1989).</li><li>Yaksh, T. L., Durant, P. A., Brent, C. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Micturition+in+rats:+a+chronic+model+for+study+of+bladder+function+and+effect+of+anesthetics.">Micturition in rats: a chronic model for study of bladder function and effect of anesthetics.</a> Am J Physiol. 251 (6 Pt 2), R1177-R1185 (1986).</li><li>Cornelissen, L. L., Misajet, B., Brooks, D. P., Hicks, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Influence+of+genetic+background+and+gender+on+bladder+function+in+the+mouse.">Influence of genetic background and gender on bladder function in the mouse.</a> Auton Neurosci. 140 (1-2), 53-58 (2008).</li><li>Lemack, G. E., Zimmern, P. E., Vazquez, D., Connell, J. D., Lin, V. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Altered+response+to+partial+bladder+outlet+obstruction+in+mice+lacking+inducible+nitric+oxide+synthase.">Altered response to partial bladder outlet obstruction in mice lacking inducible nitric oxide synthase.</a> J Urol. 163 (6), 1981-1987 (2000).</li></ol>

Optimal material and size of intravesical tubing
To determine the effect tubing diameter has on pressure recordings, we tested different microfluidic tubes; PE50 (0.58 mm ID), polyurethane PU027 (0.4 mm ID), PE25 (0.46 mm ID), and PE10 (0.28 mm ID). For each tube, pressure was recorded with the infusion pump running at 1 mL/h, while rapidly moving the tube vertically from 0 to 30 cm. Initial in vivo experiments attempted to use PE50 tubing, but were unsuccessful due to the size of tubing compared...

Filling cystometry (FC) is a diagnostic method that involves placing a catheter into the urinary bladder to record pressure during slow bladder filling. First introduced in 1927 as a clinical diagnostic method to evaluate lower urinary tract function, it has remained widely used.1 In research applications, FC can be used to test bladder function in healthy and diseased animal models and to study the effects of pharmacological agents. Rodent animal models are commonly used to investigate lower urinary tract function.2 In this group of mammals, FC was first developed for use in rats.3 Here, the methodology to implant a tube into the urinary bladder and perform FC has been well described and used by many researchers with an acceptable level of reproducibility.4 The availability of transgenic and knock out strains make mice a valuable species for numerous research areas, including the field of lower urinary tract dysfunction. The methodology used for performing mouse cystometry varies appreciably between laboratories, making it difficult to compare results.5
Compared to ex vivo models, FC preserves lower urinary tract anatomy, allowing the coordinated function between the bladder and its outlet during the storage and voiding phases of the micturition cycle to be assessed. Previous research shows that numerous, commonly used anesthetics suppress micturition contraction. Agents that preserve urinary bladder smooth muscle contraction (urethane, &#945;-chloralose, ketamine and xylazine), allowing the animal to micturate, still significantly reduce functional bladder capacity and suppress neurotransmission.6,7,8,9 Although technically more challenging, FC performed in awake ambulating animals preserves the functional integrity of the micturition reflex.
Lower urinary tract function is influenced by multiple factors, including post-operative bladder wall swelling, stress due to pain and discomfort, and environmental influences. Using a surgical technique that minimizes tissue damage during tube implantation and recording methods that reduce tube movement, while simultaneously allowing the animal to ambulate freely, are essential for obtaining accurate and reproducible recordings.
If performed adequately, in vivo FC in freely moving animals can provide data that reliably reflects physiological bladder function.10 FC in freely moving animals can provide data on the following parameters; Basal or baseline pressure: Minimum pressure between two micturitions. Intermicturition pressure: Mean pressure between two micturitions. Threshold pressure: Intravesical pressure immediately before micturition. Maximum pressure: Maximum bladder pressure during a micturition cycle. Spontaneous activity (or mean intermicturition oscillatory pressure): Intermicturition pressure minus basal pressure. Non-voiding contractions: Increase in intravesical pressure during the filling phase, not associated with the release of fluid. Bladder compliance: Bladder capacity divided by threshold pressure minus basal pressure. Micturition frequency: Number of micturitions per unit of time. Intermicturition interval: Period between two maximum voiding pressures. Bladder capacity: Infused volume divided by the number of micturitions. A detailed description of these parameters and standardized terminology has been previously published.11
FC can be performed using a continuous or single cycle intravesical infusion method. Continuous cystometry allows for recording of multiple micturition cycles and selecting representative data based on reproducibility. Its accuracy in measuring bladder capacity is limited due to the unknown residual volume. In addition, it is challenging to collect small voided volumes (which based on strain and sex vary between 30 and 184 &#181;L) in freely ambulating mice. Using this method to record voided volume is less accurate compared to an anesthetized preparation, but it is superior in that it avoids the suppressive effects of anesthetics on bladder function. Single cycle cystometry should be used to assess bladder capacity. In this method, the bladder is emptied by aspiration prior to infusion and capacity is calculated as a function of infusion rate multiplied by time to maximum pressure.
Although the technique of performing cystometry in small rodents has been published, it described the surgery performed in a rat and recommended that mouse cystometry should be performed under urethane anesthesia.10 The goal of this communication is to describe both the microsurgical techniques used to implant an intravesical tube into the dome of the urinary bladder and the experimental set-up used to record lower urinary tract function, in vivo, during continuous bladder filling and micturition in an awake freely moving mouse. In addition, experiments were performed to address how tubing length, diameter, and material, as well as the methodology for performing in vivo FC, affect the recording. This experimental protocol summarizes previously published techniques and proposes a number of modifications based on experimental results.

<table border="0" cellpadding="0" cellspacing="0" width="946">
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">Polyethylene (PE) 10 tubing</td>
			<td style="width:259px;">Instech</td>
			<td style="width:119px;">BTPE-10</td>
			<td style="width:191px;">Fits 30G connectors/plugs</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">Polyethylene (PE) 50 tubing</td>
			<td style="width:259px;">Instech</td>
			<td style="width:119px;">BTPE-50</td>
			<td>Fits 22G connectors/plugs</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">22ga single channel stainless steel swivel</td>
			<td style="width:259px;">Instech</td>
			<td style="width:119px;">375/22</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">High Carbon Steel Utility Extension Spring (9/64&#34; OD)</td>
			<td style="width:259px;">Grainger</td>
			<td style="width:119px;">1NAH1</td>
			<td>Protects PE50 tubing - Cut to length</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">22G connector</td>
			<td style="width:259px;">Instech</td>
			<td style="width:119px;">SP22/12</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">Yutaoz Professional Hot Melt Adhesive Glue Gun</td>
			<td style="width:259px;">Yutaoz</td>
			<td style="width:119px;"></td>
			<td>Use low temperature setting (100&#176;C) - Any hot melt glue gun with an adjustable temperature range will work</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">Surebonder DT-2010 all purpose glue stick</td>
			<td style="width:259px;">Surebonder</td>
			<td style="width:119px;"></td>
			<td>Any all purpose hot glue will work</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">Dumont #5 curved microforceps</td>
			<td style="width:259px;">World Precision Instruments</td>
			<td align="right">500232</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">Dumont #7 curved microforceps</td>
			<td style="width:259px;">World Precision Instruments</td>
			<td align="right">14188</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Mini dissecting scissors - straight</td>
			<td style="width:259px;">World Precision Instruments</td>
			<td align="right">503240</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Micro mosquito forceps (12.5cm)</td>
			<td style="width:259px;">World Precision Instruments</td>
			<td align="right">500451</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Dissecting scissors - straight</td>
			<td style="width:259px;">World Precision Instruments</td>
			<td align="right">14393</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">Castroviejo Needle Holder</td>
			<td style="width:259px;">World Precision Instruments</td>
			<td align="right">503258</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">Isoflurane, USP</td>
			<td style="width:259px;">Phoenix</td>
			<td style="width:119px;"></td>
			<td>2%, 1 L/min flow rate</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">Buprenorphine</td>
			<td style="width:259px;"></td>
			<td style="width:119px;"></td>
			<td>0.05mg/kg</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">0.9% Sodium Chloride Irrigation, USP</td>
			<td style="width:259px;">Baxter</td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">6-0 Ethilon black monofilament, non-absorbable suture</td>
			<td style="width:259px;">Ethicon</td>
			<td style="width:119px;"></td>
			<td>Bladder tie</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">6-0 Vicryl violet braided, absorbable suture</td>
			<td style="width:259px;">Ethicon</td>
			<td style="width:119px;"></td>
			<td>Muscle suture, running</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">6-0 Prolene blue monofilament, non-absorbable suture</td>
			<td style="width:259px;">Ethicon</td>
			<td style="width:119px;"></td>
			<td>Skin suture, vertical mattress, buried interrupted</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">KD Legato 210 infuse/withdraw pump</td>
			<td style="width:259px;">KD Scientific</td>
			<td style="width:119px;"></td>
			<td>1.5ml/hr</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">Disposable pressure transducer</td>
			<td style="width:259px;">Digitimer</td>
			<td style="width:119px;">NL108T2</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">Pressure Amplifier</td>
			<td style="width:259px;">Digitimer</td>
			<td style="width:119px;">NL108A</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">Power1401-3 data acquisition interface</td>
			<td style="width:259px;">Digitimer</td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">Spike2&#160;</td>
			<td style="width:259px;">Cambridge Electronic Design Limited</td>
			<td style="width:119px;"></td>
			<td>PC pressure recording software</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:379px;">Leica MZ6 surgical operating microscope (3.2-20X)</td>
			<td style="width:259px;">Leica Microsystems</td>
			<td style="width:119px;"></td>
			<td>Magnification</td>
		</tr>
	</tbody>
</table>

evaluating the procedure for performing awake cystometry in a mouse model

Awake filling cystometry has been used for a long time to evaluate bladder function in freely moving mice, however, the specific methods used, vary among laboratories. The goal of this study was to describe the microsurgical procedure used to implant an intravesical tube and the experimental technique for recording urinary bladder pressure in an awake, freely moving mouse. In addition, experimental data is presented to show how surgery, as well as tubing type and size, affect lower urinary tract function and recording sensitivity. The effect of tube diameter on pressure recording was assessed in both polyethylene and polyurethane tubing with different internal diameters. Subsequently, the best performing tube from both materials was surgically implanted into the dome of the urinary bladder of male C57BL/6 mice. Twelve-hour, overnight micturition frequency was recorded in healthy, intact animals and animals 2, 3, 5, and 7 days post-surgery. At harvest, bladders were assessed for signs of swelling using gross observation and were subsequently processed for pathological analysis. The greatest extent of bladder swelling was observed on day 2 and 3, which correlated with behavioral voiding data showing significantly impaired bladder function. By day 5, bladder histology and voiding frequency had normalized. Based on the literature and evidence provided by our studies, we propose the following steps for in vivo recording of intravesical pressure and voided volume in an awake mouse: 1) Perform the surgery using an operating microscope and microsurgical tools, 2) Use polyethylene-10 tubing to minimize movement artifacts, and 3) Perform cystometry on post-operative day 5, when bladder swelling resolves.

There was no significant difference between the tubing materials and diameters in the consistency of pressure rise and fall within the system during tube occlusion. Bladder wall swelling post intravesical tube implantation was significant for both polyethylene (PE) and polyurethane (PU) materials. On day 2, severe submucosal swelling developed. It occupied half the cross-section of the bladder, leading to obstruction of the lumen. On day 5, the edema resolved completely, leaving the submu...

Watch this Scientific Journal Video about Evaluating the Procedure for Performing Awake Cystometry in a Mouse Model at JoVE.com

Evaluating the Procedure for Performing Awake Cystometry in a Mouse Model

This study describes the surgical procedures and experimental techniques for performing awake cystometry in a freely moving mouse. In addition, it provides experimental evidence to support its optimization and standardization.

Awake filling cystometry has been used for a long time to evaluate bladder function in freely moving mice, however, the specific methods used, vary among ...

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