Wallner Christian, van Wissen Julia, Maas Cornelis P, Dabhoiwala Noshir F, DeRuiter Marco C, Lamers Wouter H
Department of Anatomy and Embryology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Eur Urol. 2008 Nov;54(5):1136-42. doi: 10.1016/j.eururo.2007.11.015. Epub 2007 Nov 20.
The contributions of the pudendal and levator ani nerves to the innervation of the levator ani muscle (LAM) are disputed. Because of the relatively large size of the nerves in early life, we investigated this issue in human fetuses.
(Immuno)histochemically stained serial sections of nine human fetuses (9-22 wk of gestation) were investigated. Both the left and right sides of the fetal pelves were studied individually and 3D reconstructions were prepared.
The levator ani nerve innervated the LAM in every pelvis, whereas a contribution of the pudendal nerve to the innervation of the LAM could be demonstrated in only 10 pelvic halves (56%). In 10 halves, we observed a communicating nerve branch between the pudendal and levator ani nerves that pierced the pelvic floor between the LAM and the coccygeus muscle. No sex differences were observed, but the innervation pattern did differ between the left and right side of a pelvis.
The LAM often has a dual somatic innervation with the levator ani nerve as its constant and main neuronal supply.
阴部神经和肛提肌神经对肛提肌（LAM）的神经支配作用存在争议。鉴于这些神经在生命早期相对较粗大，我们在人类胎儿中研究了这个问题。
对9例人类胎儿（妊娠9 - 22周）的（免疫）组织化学染色连续切片进行研究。对胎儿骨盆的左右两侧分别进行研究，并制作三维重建。
每例骨盆中，肛提肌神经均支配LAM，而仅在10个半侧骨盆（56%）中可证实阴部神经对LAM有神经支配作用。在10个半侧中，我们观察到阴部神经和肛提肌神经之间有一个交通神经分支，该分支在LAM和尾骨肌之间穿过盆底。未观察到性别差异，但骨盆左右两侧的神经支配模式确实有所不同。
LAM通常有双重躯体神经支配，肛提肌神经是其恒定且主要的神经供应。
