Morita T, Kizu N, Kondo S, Dohkita S, Tsuchida S
Department of Urology, Akita University School of Medicine, Japan.
Urol Int. 1988;43(3):149-56. doi: 10.1159/000281328.
The functional activity of the sphincter muscle of the urethra is known to be controlled largely by the hypogastric and pudendal nerves. It remains unknown, however, whether innervation of the muscle by these peripheral nerves is ipsi- or bilateral. In an attempt to answer this question urethral closure pressure was determined simultaneously in the anterior, posterior, right and left portions of urethral wall in dogs. The pressure measurements were stereographed with the aid of a computer (stereo-UPP) and by this means the effect of unilateral section or electrical stimulation of hypogastric and pudendal nerves on the intraurethral pressure profile was analyzed. Unilateral section or electrical stimulation of the hypogastric nerve, distal to its division, produced a fall and a rise primarily in proximal intraurethral pressure, respectively, in all four directions. There was no significant difference in this response between the involved and uninvolved sides. Unilateral section of the pudendal nerve resulted in a fall primarily in distal intraurethral pressure in all four directions. No significant difference was present between the injured and noninjured sides. In contrast, electrical stimulation of the pudendal nerve distal to the point of its division caused a rise in intraurethral pressure in all four directions, with a significantly greater pressor response on the stimulated than on the nonstimulated side. These observations suggest decussating motor innervation of the urethra by the hypogastric nerves and also the possibility of the distal urethra being ipsilaterally innervated by the pudendal nerve.
已知尿道括约肌的功能活动在很大程度上受下腹神经和阴部神经控制。然而,这些周围神经对该肌肉的支配是同侧还是双侧仍不清楚。为了回答这个问题,同时测定了犬尿道壁前、后、右、左部分的尿道闭合压。借助计算机对压力测量进行立体摄影(立体尿道压力描记法),并以此分析单侧切断或电刺激下腹神经和阴部神经对尿道内压力分布的影响。在其分支远端对下腹神经进行单侧切断或电刺激,在所有四个方向上分别主要导致尿道近端压力下降和上升。受累侧和未受累侧在这种反应上没有显著差异。单侧切断阴部神经主要导致所有四个方向上尿道远端压力下降。受伤侧和未受伤侧之间没有显著差异。相反,在其分支点远端对阴部神经进行电刺激导致所有四个方向上尿道内压力升高,刺激侧的升压反应明显大于未刺激侧。这些观察结果表明下腹神经对尿道的运动支配存在交叉,也提示尿道远端可能由阴部神经同侧支配。