Kobayashi T, Kihara K, Kageyama Y, Yamada T, Liu S, Sato K
Department of Urology and Reproductive Medicine, School of Medicine, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
Auton Neurosci. 2001 Jan 14;86(3):151-62. doi: 10.1016/S1566-0702(00)00254-X.
Spontaneous reconstruction of the sympathetic pathway projecting to the seminal tract after serious injury has not been well understood. Multiple cross-innervation mechanisms from the spinal cord via the hypogastric nerve to the seminal tract have been demonstrated currently. This study was undertaken to explore long-term spontaneous reconstruction of the canine hypogastric nerve (HGN), which controls ejaculation, after removing half of its length. Further, the study tried to identify the crossed-pathway(s) reconstructed. Responses of the vas deferens/epididymis and bladder neck to electrical stimulation of the lumbar splanchnic nerve (LSN) or the HGN were examined. In six dogs whose hypogastric nerve was injured bilaterally as described above 4 years before, corresponding to more than 20 years in human, nine (43%) and 13 (57%) of the 21 LSNs stimulated elicited elevation of vasal and bladder neck pressure, respectively. By combining re-transection of a HGN, the following pathways to the vas deferens/epididymis were identified to have been reconstructed: (1) to the ipsilateral was deferens/epididymis without crossing to the other side; (2) to the contralateral vas deferens/epididymis by crossing to the other side at the caudal mesenteric plexus (CMP); (3) to the contralateral vas deferens/epididymis by crossing to the other side from the ipsilateral HGN at the commissural branches between the right and left pelvic plexuses (CBPP); and (4) to the ipsilateral vas deferens/epididymis by crossing twice at the CMP to the other side and at the CBPP again from the contralateral HGN to the ipsilateral side. The similar patterns of reconstruction were also observed in the bladder neck. The above results indicate that the sympathetic pathways via the HGN to the canine seminal tract can be reconstructed spontaneously in a high rate over a long period after serious injuries and that their cross-innervation system can be repaired.
严重损伤后投射至精道的交感神经通路的自发重建尚未得到充分理解。目前已证实存在多种从脊髓经腹下神经至精道的交叉神经支配机制。本研究旨在探讨在切除犬腹下神经(HGN)一半长度后,控制射精的犬腹下神经的长期自发重建情况。此外,该研究试图确定重建的交叉通路。检测了输精管/附睾和膀胱颈对腰内脏神经(LSN)或腹下神经电刺激的反应。在6只4年前如上述双侧腹下神经受损的犬中,相当于人类20多年,刺激的21条腰内脏神经中有9条(43%)和13条(57%)分别引起输精管和膀胱颈压力升高。通过联合再次切断腹下神经,确定了以下至输精管/附睾的重建通路:(1)至同侧输精管/附睾而不交叉至对侧;(2)在肠系膜尾丛(CMP)交叉至对侧而到达对侧输精管/附睾;(3)在左右盆丛之间的连合支(CBPP)从同侧腹下神经交叉至对侧而到达对侧输精管/附睾;(4)在肠系膜尾丛交叉至对侧,然后在连合支再次从对侧腹下神经交叉至同侧而到达同侧输精管/附睾。在膀胱颈也观察到类似的重建模式。上述结果表明,严重损伤后,经腹下神经至犬精道的交感神经通路可在很长一段时间内以较高比例自发重建,且其交叉神经支配系统可得到修复。