{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T22:51:47Z","timestamp":1777071107358,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,7,14]],"date-time":"2015-07-14T00:00:00Z","timestamp":1436832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Gester Foundation"},{"name":"Urological Research Institute"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study sought to develop a novel animal model to study the impact of nerve\u2010sparing radical hysterectomy (<jats:styled-content style=\"fixed-case\">NSRH<\/jats:styled-content>) on female genital blood flow.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p><jats:italic>In vivo<\/jats:italic> animal study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Thirty Sprague\u2010Dawley female rats.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Female rats underwent either unilateral pelvic nerve (<jats:styled-content style=\"fixed-case\">PN<\/jats:styled-content>) crush (<jats:styled-content style=\"fixed-case\">PNC<\/jats:styled-content>;<jats:italic> n<\/jats:italic>\u00a0=\u00a09), or crush of both the <jats:styled-content style=\"fixed-case\">PN<\/jats:styled-content>s and all efferent nerves in the pelvic plexus (\u2018clock\u2010nerve crush\u2019, <jats:styled-content style=\"fixed-case\">CNC<\/jats:styled-content>;<jats:italic> n<\/jats:italic>\u00a0=\u00a09). Under anaesthesia, we electrically stimulated the crushed <jats:styled-content style=\"fixed-case\">PN<\/jats:styled-content> at 3 and 10\u00a0days after crush while monitoring blood pressure and recording clitoral and vaginal blood flows by laser Doppler. Uninjured <jats:styled-content style=\"fixed-case\">PN<\/jats:styled-content>s were stimulated as an internal control. Twelve additional rats were assigned either to bilateral <jats:styled-content style=\"fixed-case\">PNC<\/jats:styled-content> or sham surgery, and genital tissues were processed 10\u00a0days after injury for <jats:italic>in\u00a0vitro<\/jats:italic> analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Genital blood flow, <jats:styled-content style=\"fixed-case\">nNOS<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> eNOS<\/jats:styled-content>, collagen I\u2010III.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Stimulation of the crushed <jats:styled-content style=\"fixed-case\">PN<\/jats:styled-content> in both groups subjected to <jats:styled-content style=\"fixed-case\">PNC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CNC<\/jats:styled-content> induced significantly lower peak genital blood flow at 3 and 10\u00a0days (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.05) compared to stimulation of the non\u2010crushed control <jats:styled-content style=\"fixed-case\">PN<\/jats:styled-content>. The immunofluorescence and Western blot analyses revealed that all injured rats exhibited more vaginal collagen <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> and collagen I than rats did that ad undergone sham surgeries (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.05). <jats:styled-content style=\"fixed-case\">PCN<\/jats:styled-content> reduced <jats:styled-content style=\"fixed-case\">nNOS<\/jats:styled-content> expression in both clitoral and vaginal tissue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on our study it may be hypothesised that <jats:styled-content style=\"fixed-case\">NSRH<\/jats:styled-content> might cause reductions of genital blood flow and vaginal fibrosis due to neurapraxia of the pelvic nerve and reductions of <jats:styled-content style=\"fixed-case\">nNOS<\/jats:styled-content> nerve fibres in clitoral and distal vaginal tissue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable Abstract<\/jats:title><jats:p>Pelvic nerve neurapraxia during nerve\u2010sparing radical hysterectomy could lead to sexual arousal dysfunction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13506","type":"journal-article","created":{"date-parts":[[2015,7,16]],"date-time":"2015-07-16T02:58:57Z","timestamp":1437015537000},"page":"1457-1465","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Pelvic nerve injury negatively impacts female genital blood flow and induces vaginal fibrosis\u2014implications for human nerve\u2010sparing radical hysterectomy"],"prefix":"10.1111","volume":"122","author":[{"given":"F","family":"Castiglione","sequence":"first","affiliation":[{"name":"Division of Oncology\/Unit of Urology URI, IRCCS Ospedale San Raffaele Milan Italy"},{"name":"Universit\u00e0 Vita\u2010Salute San Raffaele Milan 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