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PubMedDate not supplied

Pelvic nerve plexus trauma at radical and simple hysterectomy: a quantitative study of nerve types in the uterine supporting ligaments.

OBJECTIVE: Using neuropeptide and enzyme markers to autonomic nerves, we sought to demonstrate and quantify the nerve types contained within the uterosacral ligaments (USLs) and cardinal ligaments (CLs) that are divided during radical hysterectomy (RH). METHODS: Cross-sectional biopsies were collected from the lateral third of the USL and the CL in 24 women who had an RH for cervical cancer, and from the uterine insertion of these ligaments in 11 women who had a simple hysterectomy for benign disease. We applied indirect immunofluorescence with FITC-conjugated secondary antibodies, using polyclonal primary antibodies to neuropeptide markers that predominate within somatic and autonomic nerves, to show different populations of the following nerve types within the biopsies: neuropeptide Y (NPY) and tyrosine hydroxylase (TH) for sympathetic nerves; vasoactive intestinal polypeptide (VIP) for parasympathetic nerves; substance P (SP) for nociceptive and sensory-motor nerves; and calcitonin gene-related peptide (CGRP) for sensory and sensory-motor nerves. The percentage area of immunoreactivity (PAI), determined by a computer-assisted image analyzer attached to a fluorescent microscope, was used as an objective quantitative measure of nerve density. Confocal microscopy was used to determine the composition and spatial arrangement of nerve fibers in the ligaments. RESULTS: The PAI was greater for all markers tested in both the USL and CL (P <.001) in RH compared with simple hysterectomy biopsies. For RH specimens, the PAI was greater for the sympathetic, sensory, and sensory-motor nerve markers in the USL compared with the CL (P <.01), but the PAI for VIP was similar (P >.05). Conversely, excluding the large trunks and associated ganglia, the free nerve fiber PAI in the CL was greater than that of the USL for all nerve markers (P <.001). The staining of peripheral autonomic ganglia and associated fibers, for NPY and TH, indicates that some sympathetic nerves are preganglionic with their cell bodies within the pelvic plexus. CONCLUSIONS: Significantly more autonomic nerves are transected in the more lateral division of the uterine supporting ligaments during a radical hysterectomy than during a simple hysterectomy. Sympathetic, parasympathetic, sensory, and sensory-motor nerve types are present within the CL and USL. The proportions of each nerve type differ between the two ligaments, and sympathetic nerves in the USL are the single largest nerve type. The uterine supporting ligaments are a major pathway for autonomic nerves to the pelvic organs.

Biopsy↗
PubMed2004

High-resolution MRI of the anatomy important in total mesorectal excision of the rectum.

OBJECTIVE: The surgical removal of a rectal carcinoma and the adjacent lymph nodes in an en bloc package lessens the risk of local recurrence due to residual tumor. Heightened awareness of good surgical techniques has created much interest in the anatomy involved in total mesorectal excision surgery, with particular focus on the fascial planes and nerve plexuses and their relationship to the surgical planes of excision. Clear preoperative depiction of these relationships is of value in determining tumor resectability. The aim of this study was to describe the radiologic appearance of these anatomic structures. SUBJECTS AND METHODS. High-spatial-resolution T2-weighted MRI was performed using a 1.5-T system in cadaveric sections and in patients before they underwent total mesorectal excision surgery. Anatomic dissections of sagitally sectioned hemipelves were compared with MRIs obtained in vivo to establish criteria for visualization of the structures relevant to anterior resection of the rectum. RESULTS: High-spatial-resolution MRI depicted a number of structures of importance in total mesorectal excision surgery. The mesorectal fascia, which forms the boundary of the surgical excision plane in total mesorectal excision, was identified, and the presacral fascia, peritoneal reflection, and Denonvilliers' fascia were also shown. Structures 1-2 mm in diameter were visualized because the contrast resolution afforded by T2-weighted fast spin-echo imaging permitted depiction of the inferior hypogastric nerve plexus and the fascial planes within the posterior pelvis. CONCLUSION: Anatomic landmarks important to the performance of rectal cancer surgery, in particular the mesorectal fascia, may be defined on MRI and are of potential importance in the staging of tumors, assessing resectability, planning surgery, and selecting patients for preoperative neoadjuvant therapy.

Aged↗
PubMed1975

The major ganglion in the pelvic plexus of the male rat: a histochemical and ultrastructural study.

To further evaluate the role of autonomic ganglia in the regulation of pelvic visceral activity, the neural elements in the major pelvic ganglion of the male rat have been studied with histochemixal and electron microscopic techniques. The principal findings are that the ganglion is composed of cholinergic and adrenergic ganglion cells as well as small intensely fluorescent (SIF) cells. Polarity in the ganglion is indicated by clustering of small ganglion cells which stain intensely for acetylcholinesterase (AChE) along the pelvic nerve while larger cells, with weak to moderate AChE activity, collect near small branches of the hypogatrric nerve. Some cholinergic ganglion cells are enclosed by a plexus of adrenergic terminals. SIF cells appear to be in contact with both cholinergic and adrenergic cells, although many of the fluorescent beads around adrenergic neurons may be short dendrites of ganglion cells, rather than processes of SIF cells. Two types of SIF cells may be distingiosjed on the basis of size and morphology of their granulated vesicles. Afferent synapses of the cholinergic type were common on SIF cells of the large granule and small granule type. Portions of SIF cells with large granules occur within the capsule of ganglion cells. Contacts seen here were interpreted as efferent synapses from SIF cells to the dendrites of ganglion cells.

Acetylcholinesterase↗
PubMed2002

[Formation sources and topographic characteristics of the pelvic plexus in furry animals of Canidae and Mustelidae families].

Using preparation methods, the topography and the formation sources of pelvic plexus (PP) were studied in animals of Canidae (silver-black fox, blue fox) and Mustelidae (sable, American mink) families. Maximal differences in PP topography and PP-forming nerves were found between species (Canidae-Mustelidae), whereas the intraspecies differences were less pronounced. Intraspecies sex-associated differences in PP topography are associated with only quantitative parameters, while those in PP formation sources and in peculiarities of PP-forming nerves' branching pattern are qualitative in nature. There is a distinct correlation between PP structural type (diffuse, compact, mixed) and peculiarities of its ganglionic apparatus: in diffuse type the juxta- and intraogan position of ganglia is prevalent, while in compact type the extraorgan position is more common.

Animals↗
PubMed1994

[Andrological complications after pancystoprostatovesiculectomy surgery: utility of the bulbocavernosus reflex].

The technique for radical cystoprostatectomy was modified to avoid injury to the branches of pelvic plexus that innervate the corpora cavernosa (monolateral neurovascular bundle preservation or "Nerve sparing technique"). The studies of Walsh and coll. demonstrated that the branches of pelvic plexus that innervate the corpora cavernosa are situated between the rectum and urethra and penetrate the urogenital diaphragm near to the muscular wall of the urethra. Injuries to the pelvic plexus can occur during 1) division of posterior pedicle of bladder (the seminal vesicle can be used as a landmark intraoperatively to avoid injury to pelvic plexus), 2) during apical dissection of prostate with transection of the urethra. The return of sexual function postoperatively is related to preservation of autonomic innervation; the excision of the neurovascular bundle on one side may prevent impotence in 68% patients. Our study was undertaken to identify the cause of impotence in men undergoing radical cystoprostatectomy with "Nerve sparing technique" using bulbo cavernous reflex. Our results suggest that bulbo cavernosus reflex may not be a sensitive clinical tool to establish a diagnosis of neurogenic erectile dysfunction after pelvic surgery. The Authors examine the recent neuro-uro-physiological diagnostic methods for the study of neurogenic erectile dysfunction.

Aged↗
PubMed1985

Precise localization of the autonomic nerves from the pelvic plexus to the corpora cavernosa: a detailed anatomical study of the adult male pelvis.

The anatomical location of the branches of the pelvic plexus that innervate the corpora cavernosa has been identified previously in stillborn male neonates and fetuses. Based upon these observations, the techniques of radical retropubic prostatectomy and cystectomy have been modified to avoid injury to the autonomic innervation of the corpora cavernosa. However, the exact anatomical relationships of these nerves to the prostate, urethra and other pelvic structures in adults are unclear, since the initial anatomical studies of the pelvic plexus were performed in stillborn neonates in whom the accompanying vessels and fascia had been removed. Because these nerves are microscopic in size and can only be identified by their association with other pelvic structures, it was believed that a more refined understanding of the anatomy was necessary. In an effort to identify precisely the relationship of the cavernous branches of the pelvic plexus to the lateral pelvic fascia and the branches of the prostatovesicular arteries and veins, the following study was performed. Shortly after death a 60-year-old man was perfused completely with Bouin's fixative solution. The entire bladder, prostate, urethra, penis, corpora cavernosa, rectum, and pelvic sidewall fascia and musculature were removed en bloc. The specimen was serially sectioned transversely at 10 mu thickness, and every tenth section was stained with hematoxylin and eosin. An anatomical reconstruction in 3 dimensions was performed and illustrated. Thus, the specific location of the nerves that innervate the corpora cavernosa and their important relationships to the urethra, prostatic capsule, Denonvilliers' fascia and pelvic floor vasculature have been identified.

Autonomic Nervous System↗
PubMed2001

Target specific organization and neuron types of the dog pelvic ganglia: a retrograde-tracing and immunohistochemical study.

The major pelvic ganglion in both the rat and guinea pig has been extensively studied because of its anatomical simplicity. To clarify the target specific neural pathway in the diffusely distributed pelvic ganglia of larger animals, the pelvic plexus of the female dog was investigated by retrograde tracing and immunohistochemistry. The whole mount staining of the pelvic plexus with acetylcholinesterase histochemistry revealed 70-100 ganglia of varying sizes. Neurons retrogradely labeled from the rectum were mainly found in ganglia located in the dorso-caudal part of the plexus. The majority of these were non-catecholaminergic, immunoreactive for either calbindin (Calb) or neuropeptide Y (NPY), and characteristically associated with baskets of enkephalin (ENK)-immunoreactive varicose fibers. Neurons projecting to the utero-vaginal walls were distributed in ganglia located in the ventro-caudal part of the plexus. These mainly consisted of two major neuron groups: catecholaminergic Calb-immunoreactive neurons, and non-catecholaminergic neurons containing nitric oxide synthase (NOS) and/or vasoactive intestinal peptide (VIP), which were preferentially associated with a network of ENK-immunoreactive varicose fibers. Neurons retrogradely labeled from the urinary bladder mainly occurred in ganglia located around the junction between the ureter and the bladder. These consisted of catecholaminergic Calb neurons and noncatecholaminergic neurons containing Calb or NOS. Only a few ENK-immunoreactive fibers were found within the clusters of catecholaminergic neurons. These results indicate that organ specific neurons are located in separate ganglia and have both a distinctive composition of neuron types as well as different innervation by preganglionic fibers.

Animals↗
PubMed1994

[Our experience with impotence following radical pelvic surgery].

The etiology of impotence after radical prostatectomy and radical cystoprostatectomy is unclear, although a variety of potential factors have been cited: neurogenic, psychogenic and vascular. Injury to the pelvic nerve plexus and the branches that innervate the corpora cavernosa (cavernous nerves), seems to be the most important iatrogenic factor. The Authors selected 14 patients candidate to radical prostatectomy or radical cystoprostatectomy and studied their potency pre and post operatively by anamnesis and/or Rigiscan test. The sacral-evoked potential was determined in all these patients in order to detect a neurological etiologies. The average latency of the bulbo cavernous reflex was similar in the patients that lost their potency after surgery and in the patients that didn't lose their potency after surgery. The sacral-evoked response seems not to be a diagnostic test in the study of the impotence after pelvic radical surgery.

Arteries↗
PubMed2000

[Preserving autonomic nerves in rectal surgery. Results of surgical preparation on human cadavers with fixed pelvic sections].

INTRODUCTION: Preservation of sexual function and voiding capacity after rectal cancer surgery has increased after adopting the technique of nerve-sparing dissection and total mesorectal excision. Still the rate of sexual and urinary dysfunction ranges between 25 and 67%. The precise locations where nerve damage occurs have not been looked at systematically. MATERIAL AND METHODS: In ten human corpses and two formalin-fixed human pelvises the autonomous pelvic nerves were isolated. Their relation according to surgical mobilization of the rectum were photodocumented. RESULTS: Pelvic autonomous nerves are clearly defined structures with only minor interindividual variability. The inferior mesenteric plexus forms a dense network around the inferior mesenteric artery (AMI) to a distance of 5 cm from the aorta. The distance between the lateral rectum and the pelvic plexus is only 2-3 mm. The anterior rectum is almost directly adherent to the neurovascular bundle, separated only by Denonvillier's fascia. The parasympathetic branches of the sacral segments S2-S5 cannot be isolated using the standard surgical approach. CONCLUSION: (1) The nomenclature of fascias and the course of the autonomous pelvic nerves is not clearly defined in the literature; (2) a high tie of the AMI leads to damage of the sympathetic nerves; (3) the narrow space between the anterior and lateral rectum makes sharp dissection under direct vision necessary; (4) fascias and nerves can be used as guiding structures during mobilization; (5) a preservation of selected parasympathetic roots in the small pelvis is not feasible using the standard surgical approach.

Autonomic Nervous System↗
PubMed2006

[An anatomical study on lateral ligaments of rectum].

OBJECTIVE: To identify the location and contents of the rectal lateral ligaments and its relationship with the middle rectal artery and pelvic plexus. METHODS: Twenty-nine pelvics of human cadavers were sagittally sectioned into 58 hemipelvic specimens. All of hemipelvics were dissected with sharp technique under direct vision by one surgeon. The lateral ligaments were identified and the distances from the center of its pelvic attachment to sacral promontory and coccyx were measured. Then, the lateral ligaments were transected for histologic examination. RESULTS: Lateral ligaments of rectum were found in all 58 hemipelvics. The lateral ligaments connected the posterolateral aspect of the middle 1/3 of the rectum and mesorectum to the lateral aspect of the bodies of the second, third and fourth sacral vertebrae. The distance from the lateral ligament to sacral promontory was (8.3 +/- 1.6) cm on the right side and (8.4 +/- 1.4) cm on left side. The width of lateral ligaments was (3.2 +/- 0.4) cm on the right side and (3.1 +/- 0.4) cm on the left side. The distances from lateral ligament to the coccyx on the right and left sides were (5.2 +/- 1.4) cm and (5.0 +/- 1.3) cm respectively. The content of the lateral ligaments consisted of loose connective tissue with clusters of small nerves and blood vessels. Middle rectal artery was found in 83% (48/58) of hemipelvics and 47% (27/58) of the middle rectal artery went through the lateral ligaments. The inferior hypogastric nerve plexuses were formed inside the lateral ligament, and separated the ligament into two parts. The lateral segment of the lateral ligament contained the tributaries of internal iliac artery, and the medial segment contained nerve fibers or branches to the rectum, together with the middle rectal artery. CONCLUSION: The lateral ligaments of rectum are located on the posterolateral side of the rectum, much closer to the coccyx than to the sacral promontory, consisting of connective tissue containing multiple small nerves and middle rectal artery. The lateral ligament is a pathway of blood vessels and nerve fibers toward the rectum and lymphatic vessels from the lower rectum toward the iliac lymph nodes.

Adult↗
PubMed1987

[Immediate disorders of urination following radical hysterectomy in cervix cancer].

Function of the lower urinary tract has been estimated in 23 patients with cervical carcinoma stage I-II before and after radical hysterectomy using simultaneous urethrocystometry with microtip transducer technique. The hypogastic nervous plexus could be preserved in 18 patients, but in 5 patients because of the increased radicality of the operation it was resected. Two weeks after operation no detrusor activity could be measured in all 5 patients with and in 13 out of 18 patients without plexus resection. In these patients a hypoactivity of the lower urinary tract with typical overflow incontinence and large residual urinary volume has been detected. Signs of a detrusor hyperactivity could be found in none of the 23 patients. The hyperactive bladder after radical hysterectomies often described is supposed to be a artefact caused by measuring technique. Because function of lower urinary tract has been examined in former studies with conventional cystometry with fast filling of bladder. The urethral function has been neglected more or less. The results obtained by simultaneous urethrocystometry support the assumption, that the primary reasons of the temporary and partly continuous changes of bladder and urethral function are pelvic hematomas, lymphatic vessel dysfunction, edema of bladder, direct surgical lesions of pelvic tissue and fibroses. Partial denervation may be joined partly. The most likely cause of cystometric changes is reduced distensibility of bladder and not hypertonic detrusor function.

Adult↗
PubMed1995

Human recombinant interleukin-1 beta inhibits nicotinic transmission in neurons of guinea pig pelvic plexus ganglia.

The actions of human recombinant interleukin-1 beta (hrIL-1 beta) were tested on guinea pig pelvic plexus ganglion neurons using intracellular electrophysiological methods in vitro. hrIL-1 beta caused membrane depolarization associated with a decreased input resistance or inward currents in 54% of neurons tested. hrIL-1 beta caused a hyperpolarization associated with an increase in input resistance or outward currents in 30% of neurons tested. hrIL-1 beta-evoked responses were not altered by hexamethonium (100 microM), atropine (0.5 microM), yohimbine (0.3 microM), or naloxone (1 microM), indicating that cholinergic, alpha 2-adrenergic, or opioid receptors were not involved. Drugs that inhibit Na+, Ca2+, or K+ channels did not change hrIL-1 beta-evoked responses. Stimulation of synaptic inputs to pelvic ganglion neurons evoked nicotinic cholinergic fast excitatory postsynaptic potentials (fEPSPs). hrIL-1 beta inhibited fEPSPs in 44% of neurons tested but had no effect on acetylcholine-induced depolarizations. An IL-1 beta receptor antagonist blocked all actions of hrIL-1 beta. In summary, hrIL-1 beta has excitatory and inhibitory actions on pelvic ganglion neurons. Inhibition of fEPSPs by hrIL-1 beta may be due to presynaptic inhibition of acetylcholine release.

Animals↗
PubMed2003

The role of the rectal branches of pelvic plexus in defecation and colonic motility in a canine model.

The parasympathetic nerves regulate colonic motility and defecation. The vagal nerve controls the right colon and the pelvic nerve permeates the left colon and rectum via the rectal branches of the pelvic plexus (RBPP). This investigation aimed to measure the functional changes of the colon and rectum after RBPP-transection for over six months. RBPP-transection was performed in 15 dogs. Five dogs each were sacrificed immediately, one month, and six months after RBPP-transection. The stool condition, colorectal transit, defecation reflex, colorectal response to electrical stimulation, and pathological degeneration was investigated prior to, one month after, and six months after RBPP-transection. Four of the 5 dogs observed had loose stool one month after RBPP-transection, and one of the 3 had recovered six months later. Half transit time (HTT) at transverse colon got longer in six of the 8 in one month. Six months later, HTT got shorter in three of the 4 than that of one month. Defecation reflex was not observed one month after RBPP-transection, but noted in two of the 5 six months later. These results may suggest that vagal nerve compensates for the oral site of the left colon after denervation of the pelvic nerve which is originally distributed.

Animals↗
PubMed1994

Ontogeny of neurotransmitter systems in the paracervical ganglion and uterine cervix of the rat.

BACKGROUND: The paracervical ganglia (PG) are components of the pelvic plexus that provides sensory and motor innervation to the reproductive system of the female rat. Several neurotransmitters including norepinephrine (NE), acetylcholine (ACh), neuropeptide Y (NPY), and vasoactive intestinal polypeptide (VIP) are present in neurons of the adult PG and in axons innervating the adult uterus and uterine cervix. The current study was undertaken to describe the onset of immunoreactivity of these neurotransmitters and neuropeptides during development. METHODS: Female rats, ages E18 to P36, were prepared for immunohistochemistry for TH (tyrosine hydroxylase, a marker of noradrenergic neurons), NPY, or VIP as well as the histochemical demonstration of acetylcholinesterase (AChE). RESULTS: All four markers were detected in neurons of the PG at E18. Changes in the appearance of these markers from E18 to P36 reflected previously described growth changes in the PG. Axons containing AChE, TH, NPY, or VIP were first detected within the cervix at E20. Immunopositive axons first appeared as thick, unbranched structures at the outermost portion of the cervical myometrium. Over time, these axon bundles ramified to form discrete varicose axons. The ingrowth was similar for axons containing each of the four markers. CONCLUSIONS: The relative density of each neuronal type in the PG was reflected in the density of axons containing the same marker in the cervix. Changes in neurotransmitter/neuropeptide staining of PG neurons or axons in the cervix were not observed as the animals approached puberty.

Acetylcholinesterase↗
PubMed1995

Transurethral Nd:YAG laser prostatectomy with a laterally firing fiber: local effects on tissue associated with erectile dysfunction.

BACKGROUND AND OBJECTIVES: Transurethral laser prostatectomy is anticipated to become a recognized alternative to conventional transurethral resection of the prostate. However, the effects of this procedure on the nerves of the pelvic plexus and erectile dysfunction remain unaddressed. The objective of this study was to evaluate the effects of laser energy on extent of prostatic damage as well as injury to periprostatic cavernosal nerves and erectile dysfunction in a canine model. STUDY DESIGN/MATERIALS AND METHODS: Six adult male mongrel dogs underwent transurethral laser prostatectomy at 30 (n = 3) and 40 (n = 3) watt power settings. Total laser energy delivered varied between 6,000 and 13,800 joules. Erectile function was evaluated by pelvic nerve stimulation at 2, 4, and 8 weeks. Animals were then sacrificed to assess histopathology of the prostate at each time point. RESULTS: Histopathologic changes were noted in the prostate in a dose-dependent manner and did not vary with different laser power settings. In dogs that received approximately 10,000 J, substantial prostate ablation confined within the capsule was achieved in every prostate gland. Adequate erectile responses were noted in five of six animals; all received < 10,000 J. In one animal that received a total dose of 13,800 J, an erectile response was not obtained, and histology revealed both prostatic capsule perforation in close proximity to the cavernous nerves and thermal neural damage. CONCLUSIONS: We conclude that cavernous nerve damage may result from excessive doses of laser energy during transurethral laser treatment of the prostate gland. In canines, the upper limit for periprostatic injury is between 10 and 14,000 joules.

Aluminum Silicates↗
PubMed1998

Dog model for studying detrusor instability secondary to acutely induced variable bladder outlet obstruction.

BACKGROUND: Involuntary detrusor contractions often cause irritative symptoms such as urgency and incontinence. A dog model for acutely induced variable bladder outlet resistance was developed to investigate the possible role of prostatic afferent nerve fibers in the development and maintenance of detrusor instability. METHODS: Fifty-eight mongrel dogs (weight range 19.5-36.5 kg) were divided into five groups: group I (n = 11) had surgically induced bladder outlet obstruction. Group II (n = 14) had urinary obstruction and bilateral sectioning of the lowest branches of the pelvic plexus supplying the prostate. Group III (n = 10) had prostate denervation only. Groups IV (n = 10) and V (n = 13) were sham-operated and controls, respectively. In the obstructed groups (I and II), an artificial urinary sphincter (length 4.5-6.0 cm) was placed around the bladder neck and connected to a reservoir placed subcutaneously to allow postoperative adjustments of urinary resistance. All dogs were evaluated at baseline and postoperatively at 1, 3, and 6 months with uroflowmetry, postvoid residual urine volume, cystometry as well as serum creatinine, and urinalysis. RESULTS: Occurrences of detrusor instability were not associated with prostatic denervation input. The mean peak flow rates decreased significantly in the obstructed groups at all follow-ups, but did not change significantly in the nonobstructed groups. Postoperatively, the mean maximum bladder capacity was significantly decreased for groups I and II only. However, a significant correlation between maximum bladder capacity and maximum detrusor pressure could not be detected at any time point in any of the groups. Mean postvoid residual urine volume varied considerably in all groups over time. Creation of a urinary model of infravesical obstruction was associated with considerable problems. CONCLUSIONS: In our dog model of bladder outlet obstruction, prostatic sensory nerve fibers appear not to be involved in detrusor instability. Surgical induction of a constant model of bladder outlet obstruction was difficult even in a large animal. The observations from the present study raise questions about the validity of obstructive urinary animal models.

Animals↗
PubMed1993

Pelvic plexus denervation in rats causes morphologic and functional changes of the prostate.

The effect of pelvic plexus denervation on biochemical, morphologic and functional characteristics of the rat prostate was assessed in 11 adult Sprague-Dawley rats. Unilateral denervation was performed by removing the right pelvic ganglion from the surface of the prostate; the contralateral lobe was similarly dissected, but not denervated, to serve as a control. After 15 to 18 days, the prostate was excised and specimens from both sides were used for morphologic (light and electron microscopy) and biochemical studies (sodium-dodecylsulfate-polyacrylamide gel electrophoresis). With light microscopy, histologic features of the denervated prostate showed an overall decrease in cell height and a reduction of the clear apical area of the supranuclear region. At an ultrastructural level, denervated prostatic epithelial cells showed a slight, but significant, reduction in the number of secretory granules, a decrease in the height of the supranuclear region, and fewer and less abundantly dilated apical cisternae of endoplasmic reticulum. These changes indicate a modification of the secretory activity and reflect a change in epithelial metabolism, which was further supported by the results of SDS gel electrophoresis: the denervated prostate tissue showed an increase in the expression of 108 kDa and 80 kDa protein bands and a decrease in the expression of the 45 kDa protein band. This modification in the protein content is probably temporal and would undergo further evolution with time. The finding that denervation of the prostate causes significant morphologic and functional changes of the glandular epithelium strongly suggests that prostate function is not subject solely to the regulatory influence of the hormonal milieu. It is also dependent on the anatomical and, quite possibly functional, integrity of the nervous system.

Animals↗
PubMed1982

Peripheral nerve injuries resulting from common surgical procedures in the lower portion of the abdomen.

Twenty-three patients had a painful ilioinguinal and/or iliohypogastric nerve entrapment syndrome following common surgical procedures in the lower portion of the abdomen (appendectomy, repair of inguinal hernia, and gynecologic procedures through transverse incision). The diagnostic triad of nerve entrapment after operation comprises (1) typical burning or lancinating pain near the incision that radiates to the area supplied by the nerve, (2) clear evidence of impaired sensory perception of the nerve, and (3) pain relieved by infiltration with anesthetic for local effects at the site where the two nerves leave the internal oblique muscle. Surgical repair of the scar with resection of the compromised nerve is the most effective treatment. Sixteen patients became symptom free after neurectomy, seven still suffer chronic pain in the scar.

Abdomen↗