S1 Data -

Objective
To establish experimental models of radical hysterectomy based on Querleu-Morrow classification, and clarify the quantitative evaluation of pelvic neural injuries and acute voiding changes postoperatively.
Methods
Female Sprague Dawley rats were randomized and received sham operation, type A, B1, C1 and C2 radical hysterectomies (as the injury gradually increased), respectively. The excised specimens were collected for hematoxylin and eosin staining and Pgp9.5 (pan-neuronal marker) immunohistochemistry to evaluate the facial and neural resection of paracervix. At 21 days after operation, 5 rats in each group were used for urine spot test, awake cystometry and leak point pressure test, and the other 5 ones were used for hematoxylin and eosin staining of bladder and pelvic neural plane, and Masson’s trichrome staining of bladder.
Results
Paracervical Pgp9.5 immunohistochemistry revealed that the resected neural area in C2 group was significantly larger than that in type A, B1, and C1 groups. Compared with type A and B1 groups, the excised paracervical facial area was significant higher in type C1 and C2 groups. The occurrence of urinary retention was 0%, 10%, 40% and 100% in type A, B1, C1 and C2 groups, respectively, which was further confirmed by average residual volume. The incidence of neurogenic bladder and its severity gradually increased from type A to type C2 groups, consistent with the findings of leakage point pressure, bladder size, bladder weight, pathological changes and collagen deposition. Neuropathological evaluation revealed neural injuries involved the main components of pelvic neural plane.
Conclusion
The novel rat models of radical hysterectomy based on Querleu-Morrow classification revealed the structural and functional changes of voiding after operation, which reflected the situation in humans.

研究目的
建立基于Querleu-Morrow分级的根治性子宫切除术实验模型，明确术后盆腔神经损伤与急性排尿功能变化的量化评价方法。
研究方法
将雌性斯普拉格-道利大鼠随机分组，分别接受假手术、A型、B1型、C1型及C2型根治性子宫切除术（随术式升级损伤程度逐渐加重）。收集切除标本，采用苏木精-伊红（HE）染色及Pgp9.5（泛神经元标志物）免疫组化检测，评估宫颈旁组织的筋膜与神经切除情况。术后21天，每组取5只大鼠进行尿液斑点试验、清醒状态下膀胱测压及漏尿点压试验；剩余5只大鼠用于膀胱及盆腔神经平面的苏木精-伊红染色，以及膀胱组织的马松三色染色。
研究结果
宫颈旁组织Pgp9.5免疫组化结果显示，C2组的切除神经面积显著大于A型、B1型及C1型组。与A型和B1型组相比，C1型与C2型组的宫颈旁筋膜切除面积显著更高。A型、B1型、C1型及C2组的尿潴留发生率分别为0%、10%、40%及100%，平均残余尿量进一步验证了该结果。神经源性膀胱的发生率及严重程度从A型至C2组逐渐升高，与漏尿点压、膀胱体积、膀胱重量、病理变化及胶原沉积的检测结果一致。神经病理学评估显示，神经损伤累及盆腔神经平面的主要组成结构。
研究结论
本研究建立的基于Querleu-Morrow分级的新型根治性子宫切除术大鼠模型，可反映术后排尿功能的结构与功能变化，其表现与人类临床情况相符。