基于生物力学仿真平台构建的男性下尿路控尿机制研究

The male urinary control dysfunction caused lower urinary tract symptoms, such as urinary incontinence and dysuria, and the incidence was high, which seriously affected the quality of life. The effect of first-line drugs was not ideal. Prostatic surgery was a common cause of urinary dysfunction. A new theory and method is urgently needed to study the structure and mechanism of urinary control. A new type of urinary system in the proximal and distal end of the lower urinary tract was found by our team. Then a new mechanism of urinary control was proposed: under the regulation of nerve-receptor, the synergistic effect of "bladder outlet muscle fiber system" and "rhabdosphincter-prostatic capsule system" was used to realize the control of urine. Transformation research from basic to clinical application will be performed: 1) The morphological characteristics of urinary control structures will be studied by collodium slicing technology; the distribution of smooth muscle receptor will be studied to explore the target of drug therapy. 2) Clinical application research will be performed based on microscopic sections to guide minimally invasive surgery. 3) An accurate and personalized biomechanical simulation platform for lower urinary tract will be built based on the study of morphological, real time nuclear magnetic resonance and a new immersion boundary method which was used to analyse fluid and solid coupling. The platform will be used to analyse the mechanism of urinary control. This platform will realize noninvasive urodynamic testing, individually analysis the etiology of urinary control dysfunction, provide a precise plan for clinical treatment.

男性控尿功能障碍导致尿失禁、尿梗阻等下尿路症状，发病率高，严重影响生活质量。一线药物效果不理想，前列腺手术并发控尿障碍仍普遍，迫切需要全新的理论和方法深入研究控尿结构及机制。课题组前期发现下尿路近端和远端新型控尿系统，据此本课题提出新型控尿机制：在神经-受体调控下，主要由“膀胱出口肌纤维系统”和“横纹括约肌-前列腺包膜系统”协同作用实现控尿。在本项目中我们将进行基础到临床的应用转化研究：1）应用特有的火棉胶薄型化连续切片技术，深入研究控尿及相关结构。进行平滑肌受体配布规律研究，探讨药物治疗靶点；2）以微视断层切片为基础，进行临床应用研究，指导微创手术；3）以形态学和实时核磁共振功能研究为基础，采用新型浸入边界法进行流固耦合分析，构建精准、个体化下尿路生物力学仿真平台，分析控尿系统控尿机制。本平台将实现无创尿动力学检测，个体化分析下尿路控尿功能障碍发生的病因，为临床提供精准化治疗方案。

男性控尿功能障碍导致下尿路症状，发病率高，严重影响生活质量。前列腺手术并发控尿障碍仍普遍，迫切需要新的理论和方法深入研究控尿结构及机制。基于此背景，本课题主要取得以下研究内容及科学意义：1）应用特有的火棉胶薄型化连续切片技术，对男性下尿路的形态学特点进行了深入研究。阐明了男性下尿路控尿关键结构形态学特征，发现新型控尿复合体，为控尿机制的研究打下形态学基础。为前列腺手术，保留周围神经血管束等提供了翔实的依据。2）利用三维融合技术，数字化前列腺各部空间参数。为更好地理解BPH过程中男性下尿路解剖结构改变、BPH诊断和BPH手术提供参考标准。3）下尿路生物力学仿真平台的构建及临床应用，初步实现为前列腺增生患者提供无创尿动力学检测，对患者排尿功能进行评估， 据此确定治疗方案。