Matsumoto A
First Department of Surgery, Tokyo Medical and Dental University, Japan.
Nihon Geka Gakkai Zasshi. 1994 Dec;95(12):875-86.
Clinical studies of 15 male patients with resected rectal cancer and 30 canine experiments revealed a close relationship between autonomic nerves and arterial flow in the pelvis. In clinical cases transection of the hypogastric nerve (HGN) and the sympathetic trunk did not affect the erectile function in the postoperative course. In animal experiments transection of these nerves did not affect the increase in inner pressure of the penis cavernosum. Internal pudendal arterial (IPA) flow affecting the erectile function was decreased by transection of the bilateral pelvic splanchnic nerve (PSN). Transection of the PSN on one side did not affect the erectile function. In postoperative cases in which only one side of the lower grade branches of the PSN were preserved, the erectile function was preserved. In animal experiments in which the PSN of one side was disturbed, the IPA flow of the same side decreased, while the flow of the other side increased. The effect of norepinephrine hydrochloride on canine vascular smooth muscle was examined in vitro. Vascular smooth muscle strips from the IPA, relaxed longitudinally. This relaxation was suppressed by phentolamine methylate (alpha-blocker). It is also conceivable that the erectile function through the PSN is controlled by the sympathetic nerve, not by the parasympathetic nerve.
对15例接受直肠癌切除手术的男性患者进行的临床研究以及30项犬类实验表明，自主神经与盆腔内动脉血流之间存在密切关系。在临床病例中，切断腹下神经（HGN）和交感干在术后过程中并未影响勃起功能。在动物实验中，切断这些神经并未影响阴茎海绵体内压的升高。切断双侧盆内脏神经（PSN）会使影响勃起功能的阴部内动脉（IPA）血流减少。切断一侧的PSN并不影响勃起功能。在术后仅保留一侧PSN低级分支的病例中，勃起功能得以保留。在一侧PSN受到干扰的动物实验中，同侧的IPA血流减少，而另一侧的血流增加。体外研究了盐酸去甲肾上腺素对犬血管平滑肌的作用。来自IPA的血管平滑肌条纵向松弛。这种松弛被甲基酚妥拉明（α阻滞剂）抑制。也可以想象，通过PSN的勃起功能是由交感神经而非副交感神经控制的。
