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PubMed1976

Betadrenoceptors in urinary bladder.

In presence of dibenzyline, isoproterenol and adrenaline produced impairment of the responses of the guniea-pig urinary bladder to hypogastric nerve stimulation. Submaximal responses of isolated rat and guinea-pig urinary bladders to exogenous acytylcholine were similarly inhibited by these drugs. The inhibitory effects were reversed in presence of propranolol. The extent of maximal inhibition ranged between 60 and 80 per cent. The results provide evidence for the presence of inhibitory beta adrenoceptors in the urinary bladder of rats and guinea-pigs.

Animals↗
PubMed1996

Male sexual function after autonomic nerve-preserving operation for rectal cancer.

PURPOSE: Sexual dysfunction after surgery of the rectum is a serious complication to male patients. Autonomic nerve-preserving operation for rectal cancer has been performed within the recent ten years to maintain urinary and male sexual functions without spoiling of therapeutic radicality. To clarify male sexual function as the degree of autonomic nerve-preserving operation, the function was outlined through clinical interview. METHOD: In a series of 134 male patients who were undergoing autonomic nerve-preserving operation for rectal cancer, a detailed history of postoperative sexual function was obtained by interviews. RESULTS: In 87.7 and 66.9 percent of patients, erectile and ejaculatory potencies were maintained, respectively, which were higher rates than those after extended and conventional pelvic dissections. According to the preserving extent of autonomic nerve, patients undergoing complete preserving operations showed higher rates of maintained erectile (92.9 percent) and ejaculatory functions (82.5 percent), sexual intercourse (89.9 percent), and orgasm (93.9 percent) compared with those undergoing hemilateral autonomic nerve-preserving (82.3, 47.1, 52.9, 64.7 percent) or partial pelvic plexus-preserving operation (61.1, 0, 26.3, 22.2 percent). CONCLUSION: Pelvic plexus preservation is necessary to maintain erectile potency, and both hypogastric nerve and pelvic plexus preservation are necessary to maintain ejaculate function and orgasm. To maintain satisfactory sexual function, complete autonomic nerve-preserving operation is suitable.

Aged↗
PubMed1985

The hypogastric nerve innervates a population of penile neurons in the pelvic plexus.

Retrograde dye staining, enkephalin immunocytochemistry and nerve lesion paradigms were used to determine if penile neurons in the pelvic plexus are innervated by fibers in the hypogastric nerve. In the intact major pelvic ganglion of the rat, some 80% of penile neurons are enclosed by an enkephalin-positive fiber plexus. Following surgical interruption of the pelvic nerve, 20% of penile neurons were still surrounded by an enkephalin plexus. After interruption of the pelvic nerve and the hypogastric nerve, the enkephalin plexus in the ganglion was virtually absent, including the plexus around penile neurons. Therefore, possible intrinsic sources of the enkephalin fibers such as enkephalin-positive principal neurons and small intensely fluorescent cells, do not account for the delicate enkephalin fiber system in the pelvic ganglion. It is concluded that the pelvic nerve is the major source of preganglionic innervation to penile neurons in the major pelvic ganglion. However, it is significant that the hypogastric nerve is preganglionic to about 20% of penile neurons. The pathway through the hypogastric nerve may represent an alternate vasodilator system to penile erectile tissue.

Animals↗
PubMed1984

[Adrenergic mechanisms of the cystic plexus in the cat].

Hypogastric and pelvic nerves were stimulated in experiments carried out on isolated vesical plexuses of the cat as well as intra-or extracellular recording of the activity of vesical ganglion neurons was conducted. Characteristics of evoked responses, ganglionic lability, rhythmic and posttetanic potentiation were studied. Homosynaptic presynaptic origin of posttetanic potentiation was noted. Suppression of ganglionic recording in stimulation of sympathetic fibres and in intraarterial injections of catecholamines is suggested to be connected with presynaptic adrenergic inhibition. This suggestion was confirmed in experiments with administration of reserpine and phenoxybenzidine .

Adrenergic Fibers↗
PubMed1993

Development of the pelvic plexus in human embryos and fetuses and its relationship with the pelvic viscera.

Development of the pelvic plexus is studied in 15 human embryos and 2 fetuses ranging in size from 4 to 132 mm. C.R. length. A tridimensional reconstruction of the entire pelvic block was made in two specimens (30 and 132 mm. C.R. length) 80 X. The first ganglionic elements appear in Carnegie's stage 16, but the real definition of what in the final anatomy of the plexus is described as the hypogastric ganglion (Lee-Frankenhäuser) is formed in stage 18. Complete development of the plexus occurs in stage 23. Other relevant facts are: the appearance in stage 18 of the pelvic splanchnic nerves, which are formed from S2, S3 and S4, the involvement of S1 and S5 were not observed in any case. In all specimens studied, a close proximity was seen between the pelvic plexus and genitourinary organs. Starting in stage 18, the terminal ureter consistently crosses the posterosuperior part of the pelvic plexus.

Embryonic and Fetal Development↗
PubMed1966

The characteristics of spontaneous and evoked action potentials recorded from the rabbit's uterine nerves.

1. A method is described for recording in vivo the action potentials of afferent and efferent fibres in whole nerves supplying the rabbit's uterus.2. Examination of these nerves under the light microscope and the electron microscope showed them to be composed almost entirely of non-myelinated fibres.3. Two types of spontaneous action potential were observed; one travelled at about 4 m/sec and probably came from the myelinated fibres, the other travelled at 0.4-1.4 m/sec and certainly came from non-myelinated fibres.4. The efferent fibre spikes were shown to be faster and higher than the spikes from uterine afferent fibres, but slower and smaller than spikes from broad ligament afferent fibres.5. Apart from differences in conduction velocity and height, all spikes were basically similar, lasting about 1.5 msec. The height was related to the square of the velocity. Some more complex spikes were also observed.6. The compound action potential evoked by stimulation of the uterine nerve had three peaks, conducted at 1.3, 0.8 and 0.6 m/sec, respectively, and thought to correspond to the fast afferent fibres, the efferent fibres and the slow afferent fibres, respectively. There were also some late peaks due to reflexion of the antidromic action potentials from the ganglion cells.7. Stimulation of the hypogastric nerve also evoked a compound action potential in the uterine nerves. Stimulation of the pelvic nerves had no effect.8. By means of ganglion blocking agents, the uterine ganglia were shown to lie in the pelvic plexus, peripheral to the hypogastric nerve, but central to the uterine nerves.9. It is argued that the spontaneous action potentials came from individual fibres rather than Remak bundles, and that the recording technique used detected the activity of all but the smallest fibres.

Animals↗
PubMedDate not supplied

[Neurovascular implications in total meso-rectal excisions. A prospective study of sexual function after surgery for rectal cancer].

Total mesorectal excision (TME), well established in the modern curative surgery of rectal cancer, needs further investigation, especially with regards to the preservation technic of the autonomous abdominopelvic innervation currently used to prevent or reduce the urogenital sequelae. The Authors offer a perspective study over the recovery of sexual activity in a homogeneous group of 32 male patients submitted, because of cancer, to restorative proctectomy, with anatomical preparation of the hypogastric and sacral plexus. The criteria for eligibility were the followings: male under 70 years of age, excision of the primary rectal cancer with coloanal or colo-rectal anastomosis performed at less than 5 cm from the anal verge, staging not more than T3N2M0, without previous RT or other pelvic operations and without protective enterostomy, nor local or systemic recurrences during the follow up period. The functional results obtained on the basis of a questionnaire, filled in quarterly by the patients as well as their partners for at least a year, three months after the operation were: lack of sexual disorders in 37.5%, reduction of the sexual activity (partial erection, lack of ejaculation, anorgasmy) in the 34.4%, and no sexual activity in 28.1% of the patients. After 6 months the total lack of sexual activity was observed in only 15.6% of the patients, whereas after a year 65.6% of the patients showed a normal level of sexual activity. The Authors explain the preparatory technic to approach the mesorectum sparing the autonomous nerves and discuss the two fundamental surgical-anatomical aspects of the nerve-sparing technic still not sufficiently clarified as far as the behaviour of the pelvic visceral fascia and the course of the medial-rectal artery are concerned. The results obtained even considering the limitation in the evaluation and standardization of the genito-sexual disorders, show the need to extend and deepen the study relative to the nerve-sparing technics in rectal cancer surgery.

Adult↗
PubMed1992

The effects of decentralization on substance P-immunoreactivity in the anterior major pelvic ganglion of the male guinea pig.

The anterior major pelvic ganglion (AMPG) of the male guinea pig possesses a substance P (SP)-immunoreactive peri-neuronal plexus. Selective nerve transections involving the principal inputs of the AMPG, the hypogastric and pelvic nerves, indicate that the SP-immunoreactive peri-neuronal plexus is derived from multiple sources: an extrinsic source involving both the hypogastric and pelvic nerves, and another source (possibly the projections of small intensely fluorescent cells). SP-immunoreactivity (IR) is not normally present in the neuronal perikarya of the AMPG. Evidence is presented that suggests the absence of SP-IR is due to an active suppression of SP-synthesis. This seems to be achieved by a trans-synaptic mechanism involving the hypogastric nerve which, after transection, leads to the appearance of neuronal perikarya exhibiting SP-IR (less than 1% of the total neuronal population of the AMPG). Up to 65% of the neuronal perikarya of the AMPG have the ability to synthesize SP, as demonstrated by SP-IR after 24 h in vitro. A more potent factor in the down-regulation of SP synthesis seems to be exerted by the pelvic genito-urinary organs, especially the prostate.

Animals↗
PubMed2006

Human pelvic extramural ganglion cells: a semiquantitative and immunohistochemical study.

In pelvic surgery, much attention is paid to nerve bundles but not to ganglion cells. Using serial section histology of 14 postmortem-treated hemipelvis (eight males, six females; mean, 79 years old), we examined the population number, distribution, and tyrosine hydroxylase-immunoreactivity (TH-IR; suggesting sympathetic neurons) of extramural pelvic ganglion cells. All pelvic ganglion cells were uniformly sized (25-30 microm) contrasting with small intramural rectal neurons. Abundant ganglion cells (30,000-140,000 unilaterally) existed not only along the pelvic viscera except for the rectum, but also along the hypogastric nerve, pelvic splanchnic nerve, pelvic plexus, and associated branches excluding those within the mesorectum. The intrapelvic ganglion cells outside the sympathetic trunk did not form macroscopically identifiable ganglia, but made small clusters (0.1-2.0 mm of maximum diameter) or were diffusely scattered within nerve bundles. More than half of these cells appeared TH-IR positive, although the positive/negative proportion differed between nerves and specimens. Greater numbers of ganglion cells were found in dorsosuperior sites (e.g., around the seminal vesicle) rather than in ventroinferior sites (e.g., along the urethra) in males, and vice versa in females. However, in total cell numbers, interindividual variations were evident rather than intergender difference. Due to significant interindividual variations in cell number, differences are likely to exist between patients in "resistance" to surgical stresses. We hypothesized that pelvic ganglion cells are liable to be damaged due to drying along the surgical margin, hypoxia in venous bleeding, pressure from surgical retractors, extension stress with taping and excess traction and/or direct injury with electrical scalpels.

Aged↗
PubMed2004

[Autonomic innervation of the female pelvis. Anatomic basis].

The pelvic plexus with its sympathetic (hypogastric nerves, sacral sympathetic trunk) and parasympathetic (pelvic splanchnic nerves) sources provides and distributes the autonomic nervous supply for the pelvic organs. This homogeneous autonomic nerve plate is located within and deeply to the peritoneal fold (recto-uterine in the female pelvis) lying medially to the internal iliac vessels. Autonomic nerve fibres emerge from the pelvic plexus and travel to the anterolateral aspect of the rectum and the inferolateral and posterolateral aspects of the bladder and female genital tract. In addition, pelvic organs are innervated by nerves accompanying the vessels and the ureter which penetrate the pelvic plexus. Knowledge of the topography of the pelvic plexus indicates the most common sites for iatrogenic lesions and should help us in avoiding postoperative autonomic dysfunction.

Autonomic Pathways↗
PubMed1986

The hypogastric nerve pathway to penile erectile tissue: histochemical evidence supporting a vasodilator role.

Retrograde dye staining, combined with histochemical and immunohistochemical techniques, were used to characterize penile neurons in the major pelvic ganglion of the rat. Of the penile neurons 92% were immunoreactive for vasoactive intestinal polypeptide, while 95% of penile neurons stained intensely for acetylcholinesterase. None of the neurons were immunoreactive for tyrosine hydroxylase. Penile neurons in the pelvic plexus receive preganglionic input from the pelvic and the hypogastric nerve, yet the shared histochemical features of the postganglionic neurons suggest that the two pathways have a similar role in penile erectile tissue.

Acetylcholinesterase↗
PubMed2003

Laparoscopic intersphincteric resection with coloplasty and coloanal anastomosis for mid and low rectal cancer.

BACKGROUND: The feasibility of laparoscopic rectal resection in patients with mid or low rectal cancer was studied prospectively with regard to quality of mesorectal excision, autonomic pelvic nerve preservation and anal sphincter preservation. METHODS: Laparoscopic rectal excision was performed in 32 patients (21 men) with rectal carcinoma located 5 cm from the anal verge. Most patients had T3 disease and received preoperative radiotherapy. The surgical procedure was performed 6 weeks after radiotherapy and included total mesorectal excision, intersphincteric resection, transanal coloanal anastomosis with coloplasty and loop ileostomy. RESULTS: Three patients needed conversion to a laparotomy. Postoperative morbidity occurred in ten patients, related mainly to coloplasty. Macroscopic evaluation showed an intact mesorectal excision in 29 of 32 excised specimens; microscopically, 30 of the 32 resections were R0. Sphincter preservation was achieved in 31 patients. The hypogastric nerves and pelvic plexuses were identified and preserved in 24 of the 32 patients. Sexual function was preserved in ten of 18 evaluable men. CONCLUSION: A laparoscopic approach can be considered in most patients with mid or low rectal cancer.

Adult↗
PubMed1983

Origin of peptide-containing fibers in the inferior mesenteric ganglion of the guinea-pig: immunohistochemical studies with antisera to substance P, enkephalin, vasoactive intestinal polypeptide, cholecystokinin and bombesin.

After different denervation procedures the guinea-pig inferior mesenteric ganglion was analysed by immunohistochemistry using antisera to substance P, enkephalin, vasoactive intestinal polypeptide, cholecystokinin and bombesin. The results demonstrate that each of the nerve trunks connected to the ganglion carries specific peptidergic pathways. Thus, the lumbar nerves contain substance P-immunoreactive primary afferent neurons, which to a large extent traverse the ganglion, and enkephalin-immunoreactive preganglionic neurons; the colonic nerves carry vasoactive intestinal polypeptide-, cholecystokinin- and bombesin-immunoreactive fibers from the distal colon to the ganglion; the hypogastric nerves contain vasoactive intestinal polypeptide-positive fibers from the pelvic plexus; and the intermesenteric nerve contains vasoactive intestinal polypeptide, cholecystokinin, substance P and enkephalin from divergent sources. By studying accumulations of peptides in ligated lumbar splanchnic, intermesenteric, hypogastric and colonic nerves the existence of these major peptidergic pathways was confirmed and evidence was obtained for additional, not so prominent, peptidergic projections. The results arae discussed in view of earlier morphological and physiological studies.

Animals↗
PubMed1990

Met5-enkephalin-Arg6-Gly7-Leu8-like immunoreactivity in the pelvic ganglion of the male rat: a light and electron microscopic study.

By using both light and electron microscopic immunocytochemical methods, Met5-Enkephalin-Arg6-Gly7-Leu8 (MEAGL)-like immunoreactive structures were detected in the pelvic ganglion of male rats. Denervation studies were carried out to determine the origin of these immunoreactive fibers and the projection of immunoreactive neurons within the pelvic ganglion. MEAGL-like immunoreactivity was found in numerous axon boutons, some small, intensely fluorescent (SIF) cells, and a few principal ganglion neurons. Most of the immunoreactive nerve fibers formed pericellular plexuses surrounding the ganglion cells. In addition, there were a few scattered varicose fibers. These fiber plexuses could be classified into two types: type I (approximately 90% of fibers), which consisted of 80-120 small boutons that synapsed on either the dendrites (80% of cases) or somata (20% of cases) of principal neurons; and type II (approximately 10% of fibers), which consisted of 20-40 larger boutons that formed axodendritic synapses exclusively. After transection of the hypogastric and pelvic nerves, virtually all of the pericellular fiber plexuses disappeared, whereas the scattered varicose fibers remained. According to their ultrastructure, these remaining fibers were considered to arise from SIF cells. Following the injection of Fast Blue into the bladder wall, some of the MEAGL-like immunoreactive principal neurons were retrogradely labeled. The results of this study indicate that there are two origins for the MEAGL-like immunoreactive fibers detected in the pelvic ganglion: most arise from preganglionic neurons in the spinal cord, and a small proportion may originate from intraganglionic MEAGL-like immunoreactive SIF cells or principal neurons. Some MEAGL-like immunoreactive principal neurons may project to the urinary bladder.

Animals↗
PubMed1980

Pharmacological study on sympathetic inhibition of the urinary bladder in dogs.

The sympathetic inhibitory mechanism in dog urinary bladder studied. The bladder contractions induced by electrical stimulation of the pelvic nerve both proximal and distal to the pelvic plexus and by intraarterial administration of tetramethylammonium (TMA) were inhibited by stimulation of the hypogastric nerve and intraarterial injection of catecholamines. The inhibition by hypogastric nerve stimulation was more potent at the low frequency of pelvic nerve stimulation than at the high frequency. The inhibition of contraction induced by stimulation of the pre-plexal pelvic nerve was antagonized by phentolamine and propranolol, whereas the inhibition of contraction induced by stimulation of the post-plexal pelvic nerve and by TMA treatment were antagonized only by propranolol. It is concluded that inhibition by hypogastric nerve stimulation of bladder contraction induced by pelvic nerve stimulation is composed of two different components. One occurs at the ganglia in the pelvic plexus and is mediated by alpha-adrenoceptors. The other occurs at the post-plexal pelvic pathway, probably at the ganglia in the bladder wall or on the muscle cells, and is mediated by beta-adrenoceptors. Moreover, the alpha-adrenergic action facilitated the pelvic nerve excitation in its pathway from the ganglionic cell bodies to the muscle cells.

Animals↗
PubMed1983

[Morphological and ultrastructural study of the neural pelvic plexus in the male white mouse].

The hypogastric ganglion which innerves the vas deferens and accessory glands of rat genital tract does not exist in the mouse. The mouse genital tract is innervated by a pelvic plexus made of a network of nervous fibres in which there are nervous ganglia. In these latter, there is a subpopulation of S. I. F. cells characterized by clear synaptic vesicles and a low number of dense core vesicles.

Animals↗