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Li X, Li X, Liao L. Mechanism of Action of Tibial Nerve Stimulation in the Treatment of Lower Urinary Tract Dysfunction. Neuromodulation 2024; 27:256-266. [PMID: 37178068 DOI: 10.1016/j.neurom.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/03/2023] [Accepted: 03/31/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Tibial nerve stimulation (TNS) has long been used to effectively treat lower urinary tract dysfunction (LUTD). Although numerous studies have concentrated on TNS, its mechanism of action remains elusive. This review aimed to concentrate on the mechanism of action of TNS against LUTD. MATERIALS AND METHODS A literature search was performed in PubMed on October 31, 2022. In this study, we introduced the application of TNS for LUTD, summarized different methods used in exploring the mechanism of TNS, and discussed the next direction to investigate the mechanism of TNS. RESULTS AND CONCLUSIONS In this review, 97 studies, including clinical studies, animal experiments, and reviews, were used. TNS is an effective treatment for LUTD. The study of its mechanisms primarily concentrated on the central nervous system, tibial nerve pathway, receptors, and TNS frequency. More advanced equipment will be used in human experiments to investigate the central mechanism, and diverse animal experiments will be performed to explore the peripheral mechanism and parameters of TNS in the future.
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Affiliation(s)
- Xunhua Li
- School of Rehabilitation, Capital Medical University, Department of Urology, China Rehabilitation Research Center, Beijing, China; University of Health and Rehabilitation Sciences, Qingdao, China
| | - Xing Li
- School of Rehabilitation, Capital Medical University, Department of Urology, China Rehabilitation Research Center, Beijing, China
| | - Limin Liao
- School of Rehabilitation, Capital Medical University, Department of Urology, China Rehabilitation Research Center, Beijing, China; University of Health and Rehabilitation Sciences, Qingdao, China; China Rehabilitation Science Institute, Beijing, China.
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Giannotti A, Musco S, Miragliotta V, Lazzarini G, Pirone A, Briganti A, Verardo C, Bernini F, Del Popolo G, Micera S. Swine Pudendal Nerve as a Model for Neuromodulation Studies to Restore Lower Urinary Tract Dysfunction. Int J Mol Sci 2024; 25:855. [PMID: 38255927 PMCID: PMC10815560 DOI: 10.3390/ijms25020855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Lower urinary tract dysfunction, such as incontinence or urinary retention, is one of the leading consequences of neurological diseases. This significantly impacts the quality of life for those affected, with implications extending not only to humans but also to clinical veterinary care. Having motor and sensory fibers, the pudendal nerve is an optimal candidate for neuromodulation therapies using bidirectional intraneural prostheses, paving the way towards the restoration of a more physiological urination cycle: bladder state can be detected from recorded neural signals, then an electrical current can be injected to the nerve based on the real-time need of the bladder. To develop such prostheses and investigate this novel approach, animal studies are still required since the morphology of the target nerve is fundamental to optimizing the prosthesis design. This study aims to describe the porcine pudendal nerve as a model for neuromodulation studies aiming at restoring lower urinary tract dysfunction. Five male farm pigs were involved in the study. First, a surgical procedure to access the porcine pudendal nerve without muscle resection was developed. Then, an intraneural interface was implanted to confirm the presence of fibers innervating the external urethral sphincter by measuring its electromyographic activity. Finally, the morphophysiology of the porcine pudendal nerve at the level of surgical exposure was described by using histological and immunohistochemical characterization. This analysis confirmed the fasciculate nature of the nerve and the presence of mixed fibers with a spatial and functional organization. These achievements pave the way for further pudendal neuromodulation studies by using a clinically relevant animal model with the potential for translating the findings into clinical applications.
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Affiliation(s)
- Alice Giannotti
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant’Anna, 56127 Pisa, Italy; (A.G.); (C.V.)
| | - Stefania Musco
- Neuro-Urology Department, Careggi University Hospital, 50134 Firenze, Italy; (S.M.); (G.D.P.)
| | - Vincenzo Miragliotta
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (V.M.); (G.L.); (A.P.); (A.B.)
| | - Giulia Lazzarini
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (V.M.); (G.L.); (A.P.); (A.B.)
| | - Andrea Pirone
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (V.M.); (G.L.); (A.P.); (A.B.)
| | - Angela Briganti
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (V.M.); (G.L.); (A.P.); (A.B.)
| | - Claudio Verardo
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant’Anna, 56127 Pisa, Italy; (A.G.); (C.V.)
| | - Fabio Bernini
- BioMedLab, Scuola Superiore Sant’Anna, 56127 Pisa, Italy;
| | - Giulio Del Popolo
- Neuro-Urology Department, Careggi University Hospital, 50134 Firenze, Italy; (S.M.); (G.D.P.)
| | - Silvestro Micera
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant’Anna, 56127 Pisa, Italy; (A.G.); (C.V.)
- Bertarelli Foundation Chair in Translational NeuroEngineering, Center for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland
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Kaddumi EG, Khader AA, Tahaineh S. Effect of low-threshold versus high-threshold genitalia stimuli on the cystometry parameters in male rats. Am J Physiol Regul Integr Comp Physiol 2021; 321:R595-R602. [PMID: 34431377 DOI: 10.1152/ajpregu.00081.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/17/2021] [Indexed: 11/22/2022]
Abstract
The cross talk between external genitalia and urinary bladder could be used as part of management to certain pathological conditions affecting urinary bladder. Since urinary bladder function is also affected by pathologies of other organs (e.g., colon and esophagus), the effect of genitalia stimuli on parameters of bladder function in normal or under different pathological conditions needs to be characterized. Cystometry recordings in male rats were used to examine the effect of low-threshold (LT) and high-threshold (HT) stimulation of the scrotum and penis on urinary bladder function. These effects were studied in intact, colon irritation (CI), and esophagus irritation (EI) groups. Although HT penile stimulation had a significant inhibitory effect on micturition reflex in all groups, CI hypersensitized the penile-bladder inhibitory reflex. In addition, LT penile stimulation had a significant inhibitory effect on micturition, which was significant in CI group only. On the other hand, HT penile stimulation in CI group significantly increased the timing parameters of cystometry. Whereas LT and HT penile stimuli in EI group had a significantly increasing effect on all pressure parameters of cystometry. The scrotal stimuli had minimal effect on bladder function in all groups except for HT scrotal stimulation in the CI group, where it had a significant inhibitory effect on micturition reflex and significantly increased the maximum pressure and pressure amplitude of micturition cycles. These results show that CI and EI exacerbate the effects of genitalia stimuli, especially penile stimuli, on urinary bladder function.
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Affiliation(s)
- Ezidin G Kaddumi
- Department of Basic Medical Sciences, College of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | - Ali Al Khader
- Department of Pathology and Forensic Medicine, College of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | - Sakher Tahaineh
- Department of Surgery, College of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
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Hotta H, Watanabe N. Gentle Perineal Skin Stimulation for Control of Nocturia. Anat Rec (Hoboken) 2019; 302:1824-1836. [PMID: 30980505 DOI: 10.1002/ar.24135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 10/30/2018] [Accepted: 11/18/2018] [Indexed: 11/06/2022]
Abstract
One of the major causes of nocturia is overactive bladder (OAB). Somatic afferent nerve stimuli are used for treating OAB. However, clinical evidence for the efficacy of this treatment is insufficient due to the lack of appropriate control stimuli. Studies on anesthetized animals, which eliminate emotional factors and placebo effects, have demonstrated an influence of somatic stimuli on urinary bladder functions and elucidated the underlying mechanisms. In general, the effects of somatic stimuli are dependent on the modality, location, and physical characteristics of the stimulus. Recently we showed that gentle stimuli applied to the perineal skin using a soft elastomer roller inhibited micturition contractions to a greater extent than a roller with a hard surface. Studies aiming to elucidate the neural mechanisms of gentle stimulation-induced inhibition reported that 1-10 Hz discharges of low-threshold cutaneous mechanoreceptive Aβ, Aδ, and C fibers evoked during stimulation with an elastomer roller inhibited the micturition reflex by activating the spinal cord opioid system, thereby reducing both ascending and descending transmission between bladder and pontine micturition center. The present review will provide a brief summary of (1) the effect of somatic electrical stimulation on the micturition reflex, (2) the effect of gentle mechanical skin stimulation on the micturition reflex, (3) the afferent, efferent, and central mechanisms underlying the effects of gentle stimulation, and (4) a translational clinical study demonstrating the efficacy of gentle skin stimuli for treating nocturia in the elderly with OAB by using the two roller types inducing distinct effects on rat micturition contractions. Anat Rec, 302:1824-1836, 2019. © 2019 American Association for Anatomy.
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Affiliation(s)
- Harumi Hotta
- Department of Autonomic Neuroscience, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Nobuhiro Watanabe
- Department of Autonomic Neuroscience, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Palacios JL, Arellano J, Lucio RA, Hernández ME, Manzo J, Tlachi JL, Cruz Y. Somatic innervation contributes to the release of bulbourethral gland secretion in male rats. Andrology 2018; 7:102-109. [PMID: 30230258 DOI: 10.1111/andr.12549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/19/2018] [Accepted: 08/18/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND In male rats, the bulbourethral glands (Bu-Gs) are the unique accessory sexual glands surrounded by striated musculature. However, until now the role of this musculature was unknown. OBJECTIVES (i) To characterize the Bu-Gs striated muscular layer in male rats and determine its innervation and response to genital stimulation. (ii) To reveal the role of the Bu-Gs striated musculature in the release of glandular secretion. (iii) To elucidate the effect of bilateral ablation of the Bu-Gs on copulatory behavior and seminal fluid characteristics. MATERIALS AND METHODS Adult Wistar male rats were allocated in three experiments: in Experiment 1, the Bu-Gs striated musculature, innervation and reflex activity were determined by gross anatomy and histological and electrophysiological techniques; electromyographic activity of the Bu-Gs striated musculature was evoked with genital stimulation. In Experiment 2, Bu-Gs were analyzed after copulatory behavior of intact or animals with unilateral transected motor branch of the sacral plexus (MBSP). In Experiment 3, copulatory behavior and spermatobioscopy of males with bilateral ablation of the Bu-Gs or sham surgery were analyzed. RESULTS The Bu-Gs striated fibers discharged in response to mechanostimulation of the prepuce, glans, and penile-urethra. Innervation of the Bu-Gs striated musculature originated from the MBSP; this nerve also innervates striated penile muscles. Unilateral transection of the MBSP significantly decreased the secretion from the ipsilateral Bu-G to the nerve transection. Bilateral ablation of Bu-Gs did not affect seminal plug formation but decreased semen viscosity. DISCUSSION AND CONCLUSION The Bu-Gs striated musculature contributes to expel glandular secretion during sexual intercourse. The somatic control of Bu-Gs secretion is additional to the reported autonomic innervation supplied by the cavernosus nerve, which may underlie the synthesis of secretion as well as contraction of Bu-Gs smooth muscle.
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Affiliation(s)
- J L Palacios
- Doctorado en Ciencias Biológicas, Universidad Autónoma de Tlaxcala, Tlaxcala, México
| | - J Arellano
- Doctorado en Investigaciones Cerebrales, Universidad Veracruzana, Tlaxcala, México
| | - R A Lucio
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México
| | - M E Hernández
- Centro de Investigaciones Cerebrales, Universidad Veracruzana, Tlaxcala, México
| | - J Manzo
- Centro de Investigaciones Cerebrales, Universidad Veracruzana, Tlaxcala, México
| | - J L Tlachi
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México
| | - Y Cruz
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México
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Danziger ZC, Grill WM. Sensory feedback from the urethra evokes state-dependent lower urinary tract reflexes in rat. J Physiol 2017; 595:5687-5698. [PMID: 28612936 DOI: 10.1113/jp274191] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 06/06/2017] [Indexed: 01/31/2023] Open
Abstract
KEY POINTS The lower urinary tract is regulated by reflexes responsible for maintaining continence and producing efficient voiding. It is unclear how sensory information from the bladder and urethra engages differential, state-dependent reflexes to either maintain continence or promote voiding. Using a new in vivo experimental approach, we quantified how sensory information from the bladder and urethra are integrated to switch reflex responses to urethral sensory feedback from maintaining continence to producing voiding. The results demonstrate how sensory information regulates state-dependent reflexes in the lower urinary tract and contribute to our understanding of the pathophysiology of urinary retention and incontinence where sensory feedback may engage these reflexes inappropriately. ABSTRACT Lower urinary tract reflexes are mediated by peripheral afferents from the bladder (primarily in the pelvic nerve) and the urethra (in the pudendal and pelvic nerves) to maintain continence or initiate micturition. If fluid enters the urethra at low bladder volumes, reflexes relax the bladder and evoke external urethral sphincter (EUS) contraction (guarding reflex) to maintain continence. Conversely, urethral flow at high bladder volumes, excites the bladder (micturition reflex) and relaxes the EUS (augmenting reflex). We conducted measurements in a urethane-anaesthetized in vivo rat preparation to characterize systematically the reflexes evoked by fluid flow through the urethra. We used a novel preparation to manipulate sensory feedback from the bladder and urethra independently by controlling bladder volume and urethral flow. We found a distinct bladder volume threshold (74% of bladder capacity) above which flow-evoked bladder contractions were 252% larger and evoked phasic EUS activation 2.6 times as often as responses below threshold, clearly demonstrating a discrete transition between continence (guarding) and micturition (augmenting) reflexes. Below this threshold urethral flow evoked tonic EUS activity, indicative of the guarding reflex, that was proportional to the urethral flow rate. These results demonstrate the complementary roles of sensory feedback from the bladder and urethra in regulating reflexes in the lower urinary tract that depend on the state of the bladder. Understanding the neural control of functional reflexes and how they are mediated by sensory information in the bladder and urethra will open new opportunities, especially in neuromodulation, to treat pathologies of the lower urinary tract.
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Affiliation(s)
- Zachary C Danziger
- Department of Biomedical Engineering, Florida International University, Miami, FL, USA
| | - Warren M Grill
- Department of Biomedical Engineering, Duke University, Durham, NC, USA.,Department of Neurobiology, Duke University, Durham, NC, USA
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Moazzam Z, Yoo PB. Frequency-dependent inhibition of bladder function by saphenous nerve stimulation in anesthetized rats. Neurourol Urodyn 2017. [PMID: 28640440 DOI: 10.1002/nau.23323] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
AIMS Percutaneous tibial nerve stimulation (PTNS) is an effective neuromodulation therapy for treating overactive bladder (OAB). The therapeutic effects are achieved by repeatedly applying electrical stimulation through a percutaneous needle electrode that is used to target the tibial nerve (TN). Anatomical studies indicate there can be multiple saphenous nerve (SAFN) branches located near the site of electrical stimulation, and therefore we investigated the possibility of evoking a bladder-inhibitory reflex by electrically activating the SAFN. MATERIALS AND METHODS Acute experiments were conducted in 26 urethane-anesthetized rats. Changes in bladder contraction rate (BCR) and bladder capacity were measured in response to 10-min SAFN stimulation trials. Electrical pulses were applied at 25 µA and at stimulation frequencies between 2 Hz and 50 Hz. RESULTS We report that SAFN stimulation at 20 Hz was most effective at reflexively decreasing the BCR (53.8 ± 5.4% from baseline) and also increasing the bladder capacity (145.8 ± 43.5% from baseline). In contrast, SAFN stimulation at other frequencies yielded inconsistent changes in bladder function. Carry-over effects were minimized by randomizing the sequence of SAFN stimulation trials and also by allowing the bladder to return to the baseline conditions. CONCLUSIONS With notable changes in both the BCR and bladder capacity, our findings provide evidence of a novel bladder-inhibitory reflex in anesthetized rats that is mediated by the SAFN. Further work is needed to determine the clinical relevance of this neural pathway.
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Affiliation(s)
- Zainab Moazzam
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Paul B Yoo
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.,Department of Electrical and Computer Engineering, University of Toronto, Toronto, Ontario, Canada
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8
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Lara-García M, Alvarado M, Cuevas E, Lara-García O, Sengelaub DR, Pacheco P. Hormonal Treatment Effects on the Cross-sectional Area of Pubococcygeus Muscle Fibers After Denervation and Castration in Male Rats. Anat Rec (Hoboken) 2017; 300:1327-1335. [PMID: 28176462 DOI: 10.1002/ar.23565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 07/01/2016] [Accepted: 08/22/2016] [Indexed: 11/07/2022]
Abstract
We explore the interaction of muscle innervation and gonadal hormone action in the pubococcygeus muscle (Pcm) after castration and hormone replacement. Male Wistar rats were castrated and the Pcm was unilaterally denervated; after 2 or 6 weeks, the cross-sectional area (CSA) of Pcm fibers was assessed. Additional groups of castrated rats were used to examine the effects of hormone replacement. At 2 weeks post surgeries, rats were implanted with Silastic capsules containing either dihydrotestosterone (DHT), estradiol benzoate (EB) or both hormones, and the CSA of Pcm fibers was assessed after 4 weeks of hormone treatment. At 2 weeks post surgeries, gonadectomy without hormone replacement resulted in reductions in the CSA of Pcm fibers, and denervation combined with castration increased the magnitude of this effect; further reductions in CSA were present at 6 weeks post surgeries, but again denervation combined with castration increased the magnitude of this effect. Hormone replacement with DHT resulted in hypertrophy in the CSA of nondenervated muscles compared to those of intact normal males, but this effect was attenuated in denervated muscles. Hormone replacement with EB treatment prevented further castration-induced reductions in CSA of nondenervated muscles, but denervation prevented this effect. Similar to that seen with treatment with EB alone, combined treatment with both DHT and EB prevented further reductions in CSA of Pcm fibers in nondenervated muscles, but again denervation attenuated this effect. Thus, while hormone replacement can reverse or prevent further castration-induced atrophy of Pcm fibers, these effects are dependent on muscle innervation. Anat Rec, 300:1327-1335, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Miguel Lara-García
- Departamento de Neurofisiología, Instituto de Neuroetología, Universidad Veracruzana, Xalapa, Veracruz, México
- Departamento de Endocrinología, Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México
| | - Mayvi Alvarado
- Departamento de Neurofisiología, Instituto de Neuroetología, Universidad Veracruzana, Xalapa, Veracruz, México
| | - Estela Cuevas
- Departamento de Endocrinología, Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México
| | - Omar Lara-García
- Departamento de Neurofisiología, Instituto de Neuroetología, Universidad Veracruzana, Xalapa, Veracruz, México
| | - Dale R Sengelaub
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana
| | - Pablo Pacheco
- Departamento de Neurofisiología, Instituto de Neuroetología, Universidad Veracruzana, Xalapa, Veracruz, México
- Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, DF, México
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Onda A, Uchida S, Suzuki H, Hotta H. Stimulus frequency-dependent inhibition of micturition contractions of the urinary bladder by electrical stimulation of afferent Aβ, Aδ, and C fibers in cutaneous branches of the pudendal nerve. J Physiol Sci 2016; 66:491-496. [PMID: 27384685 PMCID: PMC5045840 DOI: 10.1007/s12576-016-0468-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 06/20/2016] [Indexed: 02/02/2023]
Abstract
We aimed to examine the afferent mechanisms for the reflex inhibition of the rhythmic micturition contractions (RMCs) of the urinary bladder induced by stimulation of the perineal skin afferents in urethane-anesthetized rats. Electrical stimulation (pulse duration: 0.5 ms) was applied to the cutaneous branches of the pudendal nerve (CBPN) at frequencies of 0.1, 1, and 10 Hz for 1 min. Nerve fiber groups were defined by recording compound action potentials from CBPN. Activation of only Aβ fibers (0.2 V) produced an inhibition of RMCs at 7-11 min after the onset of stimulation (late inhibition), at any tested frequency. Additional activation of Aδ fibers (1 V) produced additional early inhibition (immediately after stimulation) at 1 and 10 Hz. Furthermore, additional activation of C fibers (10 V) at 10 Hz completely stopped RMCs for >10 min. This strong inhibition persisted after local application of capsaicin to the stimulating CBPN. We conclude that activities of Aβ, Aδ, and C afferent fibers, without capsaicin-sensitive channels, can contribute to the inhibition of bladder contractions.
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Affiliation(s)
- Akiko Onda
- Department of Autonomic Neuroscience, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan
- Division of Rheumatology and Allergy, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, 173-8606, Japan
| | - Sae Uchida
- Department of Autonomic Neuroscience, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Harue Suzuki
- Department of Autonomic Neuroscience, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan
- Graduate School of the University of Human Arts and Sciences, Saitama, 339-8539, Japan
| | - Harumi Hotta
- Department of Autonomic Neuroscience, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan.
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10
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Qin Q, Mo Q, Liu K, He X, Gao X, Zhu B. Acupuncture at homotopic acupoints exerts dual effects on bladder motility in anesthetized rats. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 15:267. [PMID: 26253168 PMCID: PMC4529689 DOI: 10.1186/s12906-015-0781-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 07/15/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND In Chinese medicine, dual effects on target organs are considered a primary characteristic of acupoint. Acupoints may be classified as heterotopic or homotopic in terms of spinal segmental innervation: homotopic acupoints contain afferent innervation in the same segment from which efferent fibers innervate target visceral organs, and heterotopic acupoints utilize different spinal segments to innervate target visceral organs than the segment receiving the afferent signal. It is well-known that dual effects of acupuncture on the bladder can be generated based on different states of the bladder, however, the dual effects of single acupoint stimulation and acupoint site-specificity (homotopic acupoints and heterotopic acupoints) on the bladder have yet to be investigated. METHODS Twenty Sprague-Dawley rats were anesthetized and the intravesical pressure was measured via a manometric balloon inserted into the bladder. The acupuncture needle was separately inserted to a depth of 4 mm at the acupoints RN1 (Huiyin), RN3 (Zhongji), BL28 (Pangguangshu), BL32 (Ciliao), RN2 (Qugu) or BL23 (Shenshu), and manually rotated right then left with a frequency of 2 Hz for 1 min. Following acupuncture stimulation, bladder pressure was recorded and compared against the pre-stimulation measurements. RESULTS During the bladder's active state, manual acupuncture (MA) at RN1, RN3, BL28, BL32 or RN2 inhibited bladder motility (P < 0.01). In the static bladder, MA at RN1, RN3, BL28, BL32, RN2 or BL23 increased bladder motility (P < 0.01). CONCLUSIONS MA at homotopic acupoints may produce dual effects on bladder motility: inhibiting bladder motility when in an active state and enhancing bladder motility when in a static state.
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Affiliation(s)
- Qingguang Qin
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
- Department of Acupuncture and Moxibustion, Henan Orthopaedics Hospital, Luoyang, 471002, Henan Province, China.
| | - Qian Mo
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| | - Kun Liu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Xun He
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Xinyan Gao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Bing Zhu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
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11
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Juárez R, Zempoalteca R, Pacheco P, Lucio RA, Medel A, Cruz Y. Activity of the external urethral sphincter evoked by genital stimulation in male rats. Neurourol Urodyn 2015; 35:914-919. [DOI: 10.1002/nau.22850] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 07/22/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Raúl Juárez
- Doctorado en Ciencias Biológicas; Universidad Autónoma de Tlaxcala; Tlaxcala México
| | - René Zempoalteca
- Centro Tlaxcala de Biología de la Conducta; Universidad Autónoma de Tlaxcala; Tlaxcala México
| | - Pablo Pacheco
- Instituto de Investigaciones Biomédicas; UNAM; D.F. México
| | - Rosa Angélica Lucio
- Centro Tlaxcala de Biología de la Conducta; Universidad Autónoma de Tlaxcala; Tlaxcala México
| | - Alfonso Medel
- Centro Tlaxcala de Biología de la Conducta; Universidad Autónoma de Tlaxcala; Tlaxcala México
| | - Yolanda Cruz
- Doctorado en Ciencias Biológicas; Universidad Autónoma de Tlaxcala; Tlaxcala México
- Centro Tlaxcala de Biología de la Conducta; Universidad Autónoma de Tlaxcala; Tlaxcala México
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Kovacevic M, Yoo PB. Reflex neuromodulation of bladder function elicited by posterior tibial nerve stimulation in anesthetized rats. Am J Physiol Renal Physiol 2015; 308:F320-9. [DOI: 10.1152/ajprenal.00212.2014] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Although posterior tibial nerve stimulation (PTNS) has been shown in both clinical and animal studies to elicit bladder-inhibitory reflexes, our understanding of the role of posterior tibial nerve (PTN) afferents that elicit these responses is significantly limited. To this end, we investigated the effects of frequency-dependant PTNS in urethane-anesthetized rats undergoing repeated urodynamic fills. Nerve stimulation trials (10 min) resulted in statistically significant inhibition of the urinary bladder, both during and after nerve stimulation ( P < 0.05). PTNS applied at 5 Hz resulted in both acute and prolonged changes that corresponded to 38.0% and 34.1% reductions in the bladder contraction frequency, respectively. In contrast, PTNS applied at 10 Hz could only elicit an acute decrease (22.9%) in bladder activity. Subsequent electrical activation of individual PTN branches (lateral or medial plantar nerves) confirmed that these bladder reflexes are mediated by specific subsets of the PTN trunk. Both acute and prolonged inhibition of the bladder were achieved by electrical stimulation of the lateral plantar (10 and 20 Hz) and medial plantar (5 and 10 Hz) nerves. Finally, we report a bladder-excitatory reflex that is elicited by electrical activation of either the PTN trunk or lateral plantar nerve at 50 Hz. This study shows that multiple bladder reflexes are tuned to specific subsets of nerve afferents and stimulation frequencies, each of which provide novel insights into the physiological effects of PTNS.
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Affiliation(s)
- Mario Kovacevic
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada; and
| | - Paul B. Yoo
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada; and
- Department of Electrical and Computer Engineering, University of Toronto, Toronto, Ontario, Canada
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Cruz Y, Pastelín C, Balog BM, Zaszczurynski PJ, Damaser MS. Somatomotor and sensory urethral control of micturition in female rats. Am J Physiol Renal Physiol 2014; 307:F1207-14. [PMID: 25339694 DOI: 10.1152/ajprenal.00255.2014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
In rats, axons of external urethral sphincter (EUS) motoneurons travel through the anastomotic branch of the pudendal nerve (ABPD) and anastomotic branch of the lumbosacral trunk (ABLT) and converge in the motor branch of the sacral plexus (MBSP). The aim of the present study was to determine in female rats the contribution of these somatomotor pathways and urethral sensory innervation from the dorsal nerve of the clitoris on urinary continence and voiding. EUS electromyographic (EMG) activity during cystometry, leak point pressure (LPP), and voiding efficiency (VE) were assessed in anesthetized virgin Sprague-Dawley female rats before and after transection of the above nerve branches. Transection of the MBSP eliminated EUS EMG, decreased LPP by 50%, and significantly reduced bladder contraction duration, peak pressure, intercontraction interval, and VE. Transection of the ABPD or ABLT decreased EUS EMG discharge and LPP by 25% but did not affect VE. Transection of the dorsal nerve of the clitoris did not affect LPP but reduced contraction duration, peak pressure, intercontraction interval, and VE. We conclude that somatomotor control of micturition is provided by the MBSP with axons travelling through the ABPD and ABLT. Partial somatomotor urethral denervation induces mild urinary incontinence, whereas partial afferent denervation induces voiding dysfunction. ABPD and ABLT pathways could represent a safeguard ensuring innervation to the EUS in case of upper nerve damage. Detailed knowledge of neuroanatomy and functional innervation of the urethra will enable more accurate animal models of neural development, disease, and dysfunction in the future.
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Affiliation(s)
- Yolanda Cruz
- Centro Tlaxcala Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México
| | - César Pastelín
- Centro Tlaxcala Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México; Doctorado en Neuroetología, Universidad Veracruzana, Xalapa, Veracruz, México
| | - Brian M Balog
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio
| | - Paul J Zaszczurynski
- Advanced Platform Technology Center, Louis Stokes Veterans Affairs Medical Center, Cleveland, Ohio; and
| | - Margot S Damaser
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio; Advanced Platform Technology Center, Louis Stokes Veterans Affairs Medical Center, Cleveland, Ohio; and Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
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Localization and neurochemical features of the sympathetic trunk ganglia neurons projecting to the urethral muscle. An experimental study in a porcine animal model. Ann Anat 2014; 196:206-16. [DOI: 10.1016/j.aanat.2013.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 12/06/2013] [Accepted: 12/10/2013] [Indexed: 12/22/2022]
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15
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Juárez R, Cruz Y. Urinary and ejaculatory dysfunction induced by denervation of specific striated muscles anatomically related to the urethra in male rats. Neurourol Urodyn 2013; 33:437-42. [DOI: 10.1002/nau.22432] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 04/18/2013] [Indexed: 01/23/2023]
Affiliation(s)
- Raúl Juárez
- Maestría en Ciencias Biológicas; Universidad Autónoma de Tlaxcala; Tlaxcala México
| | - Yolanda Cruz
- Centro Tlaxcala de Biología de la Conducta; Universidad Autónoma de Tlaxcala; Tlaxcala México
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Ejaculatory Responses are Inhibited by a New Chemical Entity, DA-8031, in Preclinical Rodent Models of Ejaculation. Urology 2013; 81:920.e13-8. [DOI: 10.1016/j.urology.2012.12.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 11/30/2012] [Accepted: 12/04/2012] [Indexed: 01/17/2023]
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17
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Tovar A, Lara-Garcia M, Cruz Y, Pacheco P. Dorsal root activity evoked by stimulation of vagina–cervix–uterus junction in the rat. Brain Res 2013; 1496:49-54. [DOI: 10.1016/j.brainres.2012.12.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 12/16/2012] [Accepted: 12/17/2012] [Indexed: 11/16/2022]
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18
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A gentle mechanical skin stimulation technique for inhibition of micturition contractions of the urinary bladder. Auton Neurosci 2012; 167:12-20. [DOI: 10.1016/j.autneu.2011.11.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 11/10/2011] [Accepted: 11/14/2011] [Indexed: 02/01/2023]
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Juárez M, Hernández I, Cruz Y. Genitourinary dysfunction in male rats after bilateral neurectomy of the motor branch of the sacral plexus. Neurourol Urodyn 2012; 31:1288-93. [PMID: 22447388 DOI: 10.1002/nau.22242] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 02/22/2012] [Indexed: 12/18/2022]
Abstract
AIMS To determine the contribution of the striated musculature anatomically related to the urethra on urinary continence in conscious male rats. We tested whether the bilateral neurectomy of the motor branch of the sacral plexus (MBSP), a nerve that innervates the bulbospongiosus, ischiocavernosus, and external urethral sphincter, is a reliable procedure to induce changes in voiding pattern that can be used as indicators of urinary incontinence in unanesthetized male rats. METHODS Micturition behavior was videotaped and urinary parameters measured 24 h before and at day 2 and 10 after surgery. RESULTS Intact animals have a stereotyped behavior of micturition consisting in urination in the corner of the cage. Neurectomized animals lost place preference for voiding demonstrated by leakage of urine throughout the cage while eating, walking, or sleeping. Voiding frequency was double and voiding duration was triple the amount before surgery. Urine flow rate and voiding volume were also significantly decreased. Necropsy showed that 10 days post-denervation semen material was accumulated in the urethra and in the bladder. CONCLUSION In male rats the perineal striated muscles are crucial to maintaining normal urinary continence, preventing retrograde ejaculation, and to expelling urine and seminal secretions. Bilateral neurectomy of the MBSP may not be appropriate for long term survival urinary studies because effects on urinary parameters can be contaminated and/or masked by impaired seminal fluid expulsion, as a consequence of impairment of striated urethral muscle function.
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Affiliation(s)
- Margarita Juárez
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, México
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20
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Chen SC, Cheng CL, Fan WJ, Chen JJJ, Lai CH, Peng CW. Effect of a 5-HT1A receptor agonist (8-OH-DPAT) on external urethral sphincter activity in a rat model of pudendal nerve injury. Am J Physiol Regul Integr Comp Physiol 2011; 301:R225-35. [PMID: 21490366 DOI: 10.1152/ajpregu.00260.2010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Although serotonergic agents have been used to treat patients with stress urinary incontinence, the characteristics of the external urethral sphincter (EUS) activity activated by 5-HT receptors have not been extensively studied. This study examined the effects of the 5-HT(1A) receptor agonist, 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT), on the EUS-electromyography and resistance of the urethra in a rat model with bilateral pudendal nerve injury (BPNI). Two measurements were utilized to assess the effects of the drug on bladder and urethral functions: the simultaneous recordings of transvesical pressure under isovolumetric conditions [isovolumetric intravesical pressure (IVP)] and urethral perfusion pressure, and the simultaneous recordings of IVP during continuously isotonic transvesical infusion with an open urethra (isotonic IVP) and EUS-electromyography. This study also evaluated the urethral continence using leak point pressure testing. The urethral perfusion pressure and leak point pressure measurements of BPNI rats reveal that 8-OH-DPAT significantly increased urethral resistance during the bladder storage phase, yet decreased resistance during the voiding phase. The entire EUS burst period was significantly prolonged, within which the average silent period increased and the frequency of burst discharges decreased. 8-OH-DPAT also improved the voiding efficiency, as evidenced by the detection of decreases in the contraction amplitude and residual volume, with increases in contraction duration and voided volume. These findings suggest that 8-OH-DPAT not only improved continence function, but also elevated the voiding function in a BPNI rat model.
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Affiliation(s)
- Shih-Ching Chen
- Dept. of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, No. 250, Wuxing St., Taipei 11031, Taiwan
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21
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Diaz R, Garcia LI, Locia J, Silva M, Rodriguez S, Perez CA, Aranda-Abreu GE, Manzo J, Toledo R, Hernandez ME. Histological modifications of the rat prostate following transection of somatic and autonomic nerves. AN ACAD BRAS CIENC 2010; 82:397-404. [PMID: 20563420 DOI: 10.1590/s0001-37652010000200015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2009] [Accepted: 01/25/2010] [Indexed: 11/21/2022] Open
Abstract
It is known that hormones influence significantly the prostate tissue. However, we reported that mating induces an increase in androgen receptors, revealing a neural influence on the gland. These data suggested that somatic afferents (scrotal and genitofemoral nerves) and autonomic efferents (pelvic and hypogastric nerves) could regulate the structure of the prostate. Here we assessed the role of these nerves in maintaining the histology of the gland. Hence, afferent or efferent nerves of male rats were transected. Then, the ventral and dorsolateral regions of the prostate were processed for histology. Results showed that afferent transection affects prostate histology. The alveoli area decreased and increased in the ventral and dorsolateral prostate, respectively. The epithelial cell height increased in both regions. Efferent denervation produced dramatic changes in the prostate gland. The tissue lost its configuration, and the epithelium became scattered and almost vanished. Thus, afferent nerves are responsible for spinal processes pertaining to the trophic control of the prostate, activating its autonomic innervation. Hence, our data imply that innervation seems to be synergic with hormones for the healthy maintenance of the prostate. Thus, it is suggested that some prostate pathologies could be due to the failure of the autonomic neural pathways regulating the gland.
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22
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Thor KB, de Groat WC. Neural control of the female urethral and anal rhabdosphincters and pelvic floor muscles. Am J Physiol Regul Integr Comp Physiol 2010; 299:R416-38. [PMID: 20484700 PMCID: PMC2928615 DOI: 10.1152/ajpregu.00111.2010] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Accepted: 05/11/2010] [Indexed: 01/20/2023]
Abstract
The urethral rhabdosphincter and pelvic floor muscles are important in maintenance of urinary continence and in preventing descent of pelvic organs [i.e., pelvic organ prolapse (POP)]. Despite its clinical importance and complexity, a comprehensive review of neural control of the rhabdosphincter and pelvic floor muscles is lacking. The present review places historical and recent basic science findings on neural control into the context of functional anatomy of the pelvic muscles and their coordination with visceral function and correlates basic science findings with clinical findings when possible. This review briefly describes the striated muscles of the pelvis and then provides details on the peripheral innervation and, in particular, the contributions of the pudendal and levator ani nerves to the function of the various pelvic muscles. The locations and unique phenotypic characteristics of rhabdosphincter motor neurons located in Onuf's nucleus, and levator ani motor neurons located diffusely in the sacral ventral horn, are provided along with the locations and phenotypes of primary afferent neurons that convey sensory information from these muscles. Spinal and supraspinal pathways mediating excitatory and inhibitory inputs to the motor neurons are described; the relative contributions of the nerves to urethral function and their involvement in POP and incontinence are discussed. Finally, a detailed summary of the neurochemical anatomy of Onuf's nucleus and the pharmacological control of the rhabdosphincter are provided.
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Affiliation(s)
- Karl B Thor
- Urogenix, Inc., Durham, North Carolina, USA.
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23
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Jiang HH, Salcedo LB, Song B, Damaser MS. Pelvic floor muscles and the external urethral sphincter have different responses to applied bladder pressure during continence. Urology 2010; 75:1515.e1-7. [PMID: 20206969 PMCID: PMC2879447 DOI: 10.1016/j.urology.2009.11.065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Revised: 11/11/2009] [Accepted: 11/24/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To determine the functional innervation of the pelvic floor muscles (PFM) and whether there is PFM activity during an external pressure increase to the bladder in female rats. METHODS Thirty-one female adult virgin Sprague-Dawley rats received an external increase in bladder pressure until urinary leakage was noted while bladder pressure was recorded (leak point pressure [LPP]) under urethane anesthesia. Six of the rats underwent repeat LPP testing after bilateral transection of the levator ani nerve. Another 6 rats underwent repeat LPP testing after bilateral transection of the pudendal nerve. Simultaneous recordings of PFM (pubo- and iliococcygeus muscles), electromyogram (EMG), and external urethral sphincter (EUS) EMG were recorded during cystometry and LPP testing. RESULTS Thirteen rats (42%) showed tonic PFM EMG activity during filling cystometry. Eighteen rats (58%) showed no tonic PFM EMG activity at baseline, but PFM EMG could be activated by pinching the perineal skin. This activity could be maintained unless voiding occurred. The external increase in bladder pressure caused significantly increased EUS EMG activity as demonstrated by increased amplitude and frequency. However, there was no such response in PFM EMG. LPP was not significantly different after levator ani nerve transection, but was significantly decreased after pudendal nerve transection. CONCLUSIONS PFM activity was not increased during external pressure increases to the bladder in female rats. Experimental designs using rats should consider this result. The PFM, unlike the EUS, does not contribute to the bladder-to-urethra continence reflex. PFM strengthening may nonetheless facilitate urinary continence clinically by stabilizing the bladder neck.
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Affiliation(s)
- Hai-Hong Jiang
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH
- Southwest Hospital, Third Military Medical University, Chongqing, China
| | | | - Bo Song
- Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Margot S. Damaser
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH
- Biomedical Engineering Dept, Cleveland Clinic, Cleveland, OH
- Research Service, Louis Stokes VA Medical Center, Cleveland, OH
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24
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Kiasalari Z, Salehi I, Zhong Y, McMahon SB, Michael-Titus AT, Michael GJ. Identification of perineal sensory neurons activated by innocuous heat. J Comp Neurol 2010; 518:137-62. [PMID: 19937707 DOI: 10.1002/cne.22187] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
C-fiber sensory neurons comprise nociceptors and smaller populations of cells detecting innocuous thermal and light tactile stimuli. Markers identify subpopulations of these cells, aiding our understanding of their physiological roles. The transient receptor potential vanilloid 1 (TRPV1) cation channel is characteristic of polymodal C-fiber nociceptors and is sensitive to noxious heat, irritant vanilloids, and protons. By using immunohistochemistry, in situ hybridization, and retrograde tracing, we anatomically characterize a small subpopulation of C-fiber cells that express high levels of TRPV1 (HE TRPV1 cells). These cells do not express molecular markers normally associated with C-fiber nociceptors. Furthermore, they express a unique complement of neurotrophic factor receptors, namely, the trkC receptor for neurotrophin 3, as well as receptors for neurturin and glial cell line-derived neurotrophic factor. HE TRPV1 cells are distributed in sensory ganglia throughout the neuraxis, with higher numbers noted in the sixth lumbar ganglion. In this ganglion and others of the lumbar and sacral regions, 75% or more of such HE TRPV1 cells express estrogen receptor alpha, suggestive of their regulation by estrogen and a role in afferent sensation related to reproduction. Afferents from these cells provide innervation to the hairy skin of the perineal region and can be activated by thermal stimuli from 38 degrees C, with a maximal response at 42 degrees C, as indicated by induction of extracellular signal-regulated kinase phosphorylation. We hypothesize that apart from participating in normal thermal sensation relevant to thermoregulation and reproductive functions, HE TRPV1 cells may mediate burning pain in chronic pain syndromes with perineal localization.
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Affiliation(s)
- Zahra Kiasalari
- Queen Mary University of London, Bart's and The London School of Medicine and Dentistry, Centre for Neuroscience & Trauma, Blizard Institute of Cell and Molecular Science, London, E1 2AT, UK
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Birder L, de Groat W, Mills I, Morrison J, Thor K, Drake M. Neural control of the lower urinary tract: peripheral and spinal mechanisms. Neurourol Urodyn 2010; 29:128-39. [PMID: 20025024 PMCID: PMC2910109 DOI: 10.1002/nau.20837] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This review deals with individual components regulating the neural control of the urinary bladder. This article will focus on factors and processes involved in the two modes of operation of the bladder: storage and elimination. Topics included in this review include: (1) The urothelium and its roles in sensor and transducer functions including interactions with other cell types within the bladder wall ("sensory web"), (2) The location and properties of bladder afferents including factors involved in regulating afferent sensitization, (3) The neural control of the pelvic floor muscle and pharmacology of urethral and anal sphincters (focusing on monoamine pathways), (4) Efferent pathways to the urinary bladder, and (5) Abnormalities in bladder function including mechanisms underlying comorbid disorders associated with bladder pain syndrome and incontinence.
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Affiliation(s)
- L Birder
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
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26
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Shehab SAS. Acute and chronic sectioning of fifth lumbar spinal nerve has equivalent effects on the primary afferents of sciatic nerve in rat spinal cord. J Comp Neurol 2009; 517:481-92. [PMID: 19790268 DOI: 10.1002/cne.22163] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The mechanism of neuropathic pain may be associated with sprouting of uninjured primary afferents of peripheral nerves into regions of the spinal cord denervated through peripheral injury. However, this remains controversial. Therefore, the purpose of the present investigation was, first, to determine in detail the central distributions of the unmyelinated primary afferents of each of the L4, L5, and L6 components of sciatic nerve, then to assess the distribution of afferent sciatic terminals following acute and chronic injury to (L5) nerve. First, we injected isolectin B4 (IB4), into the sciatic nerves in three groups of rats, each of which had two of the three L4, L5, or L6 components ligated and cut, and the one remaining, uninjured. Although the terminal labelling found in the L5 segment of the spinal cord originated from the L5 component, some terminal labelling remained in cases when either the L4 or L6 component was intact. Second, tracers transported in predominantly unmyelinated (IB4 and WGA-HRP) or myelinated (cholera toxin subunit B) nerves were injected into the sciatic nerve following acute or chronic (21-day) injury restricted to the L5 component. In each case, the central distribution of nerve terminals in the spinal dorsal horn was equivalent following either acute or chronic injury to the L5 component. Consequently, these data provide no support for the suggestion that neuropathic pain in spinal ligation model results from uninjured L4 and L6 components sprouting to occupy sites vacated by the injured L5 component of the sciatic nerve.
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Affiliation(s)
- Safa Aldeen S Shehab
- Department of Anatomy, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
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27
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Yang Z, Dolber PC, Fraser MO. Differential vulnerabilities of urethral afferents in diabetes and discovery of a novel urethra-to-urethra reflex. Am J Physiol Renal Physiol 2009; 298:F118-24. [PMID: 19864303 DOI: 10.1152/ajprenal.00281.2009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Urethral reflexes are important regulators of micturition, and impairment of urethral afferent neuronal function may disrupt coordinated bladder and urethral activity, thereby contributing to voiding dysfunction in lower urinary tract disorders. Chemical stimulation by intraurethral irritant solution perfusion was used to determine whether urethral afferent neuronal function is altered in diabetes mellitus (DM). Sprague-Dawley rats were studied 10 wk after streptozotocin injection to induce DM or vehicle alone. Escalating doses of capsaicin (0.1-30 microM) or acetic acid (0.01-1%; AA) were perfused intraurethrally while recording isovolumetric bladder activity, urethral perfusion pressure, and electromyography of the external urethral sphincter (EUS-EMG). Some rats were additionally treated with alpha-bungarotoxin, hexamethonium, or bilateral transection of the sensory branches of the pudendal nerves (PudSNx). Intraurethral capsaicin inhibited bladder contractions in six out of seven control rats but not in any of six DM rats. Low-frequency oscillations (LFOs) of intraurethral pressure were observed in five out of six control rats with capsaicin-induced bladder inhibition. In contrast, intraurethral AA inhibited bladder contractions and enhanced tonic EUS-EMG activity in six out of six control and five out of six DM rats. LFOs occurred in four out of six control and three of five DM rats with AA-induced bladder inhibition. Chemically induced bladder inhibition and LFOs were not prevented by alpha-bungarotoxin but were eliminated by PudSNx and hexamethonium. Finally, LFOs were followed by phasic EUS activity. These findings show that DM affects urethral afferent neurons differentially, compromising those expressing TRPV1 receptors. Urethral smooth muscle LFOs are neurogenically mediated and induce EUS activity, revealing the existence of a hitherto undescribed reflex pathway: a smooth-to-striated muscle urethra-to-urethra reflex.
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Affiliation(s)
- Zhongguang Yang
- Division of Urology, Department of Surgery, Veterans Affairs Medical Center, Durham, North Carolina, USA
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28
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Allard J, Reynolds DS, Edmunds NJ. Potentiation of reflex erectile responses in the anaesthetized rat by the selective melanocortin receptor 4 agonist MB243. BJU Int 2008; 102:1029-33. [DOI: 10.1111/j.1464-410x.2008.07751.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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29
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Allard J, Edmunds N. Reflex penile erection in anesthetized mice: An exploratory study. Neuroscience 2008; 155:283-90. [DOI: 10.1016/j.neuroscience.2008.05.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2008] [Revised: 05/09/2008] [Accepted: 05/20/2008] [Indexed: 10/22/2022]
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Pastelín CF, Zempoalteca R, Pacheco P, Downie JW, Cruz Y. Sensory and somatomotor components of the “sensory branch” of the pudendal nerve in the male rat. Brain Res 2008; 1222:149-55. [DOI: 10.1016/j.brainres.2008.05.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Revised: 05/06/2008] [Accepted: 05/06/2008] [Indexed: 10/22/2022]
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31
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Carro-Juárez M, Rodríguez-Manzo G. The spinal pattern generator for ejaculation. ACTA ACUST UNITED AC 2008; 58:106-20. [PMID: 18241924 DOI: 10.1016/j.brainresrev.2007.12.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2007] [Revised: 11/14/2007] [Accepted: 12/05/2007] [Indexed: 01/08/2023]
Affiliation(s)
- Miguel Carro-Juárez
- Laboratorio de Comportamiento Reproductivo, Escuela de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Tlaxcala, C.P.90000, Tlaxcala, México.
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32
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Peng CW, Chen JJJ, Cheng CL, Grill WM. Improved bladder emptying in urinary retention by electrical stimulation of pudendal afferents. J Neural Eng 2008; 5:144-54. [PMID: 18430976 DOI: 10.1088/1741-2560/5/2/005] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Urinary retention is the inability to empty the bladder completely, and may result from bladder hypocontractility, increases in outlet resistance or both. Chronic urinary retention can lead to several urological complications and is often refractory to pharmacologic, behavioral and surgical treatments. We sought to determine whether electrical stimulation of sensory fibers in the pudendal nerve could engage an augmenting reflex and thereby improve bladder emptying in an animal model of urinary retention. We measured the efficiency of bladder emptying with and without concomitant electrical stimulation of pudendal nerve afferents in urethane-anesthetized rats. Voiding efficiency (VE = voided volume/initial volume) was reduced from 72 +/- 7% to 29 +/- 7% following unilateral transection of the sensory branch of the pudendal nerve (UST) and from 70 +/- 5% to 18 +/- 4% following bilateral transection (BST). Unilateral electrical stimulation of the proximal transected sensory pudendal nerve during distention-evoked voiding contractions significantly improved VE. Low-intensity stimulation at frequencies of 1-50 Hz increased VE to 40-51% following UST and to 39-49% following BST, while high-intensity stimulation was ineffective at increasing VE. The increase in VE was mediated by increases in the duration of distention-evoked voiding bladder contractions, rather than increases in contraction amplitude. These results are consistent with an essential role for pudendal sensory feedback in efficient bladder emptying, and raise the possibility that electrical activation of pudendal nerve afferents may provide a new approach to restore efficient bladder emptying in persons with urinary retention.
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Affiliation(s)
- Chih-Wei Peng
- Department of Biomedical Engineering, Duke University, Hudson Hall 136, Box 90281, Durham, NC 27708-0281, USA
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Cothron KJ, Massey JM, Onifer SM, Hubscher CH. Identification of penile inputs to the rat gracile nucleus. Am J Physiol Regul Integr Comp Physiol 2008; 294:R1015-23. [PMID: 18171689 DOI: 10.1152/ajpregu.00656.2007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Neurons in the medullary reticular formation (MRF) of the rat receive a vast array of urogenital inputs. Using select acute and chronic spinal cord lesions to identify the location of the ascending neural circuitries providing either direct or indirect inputs to MRF from the penis, our previous studies demonstrated that the dorsal columns and dorsal half of the lateral funiculus convey low- and high-threshold inputs, respectively. In the present study, the gracile nucleus was targeted as one of the likely sources of low-threshold information from the penis to MRF. Both electrophysiological recordings and neuroanatomical tracing [injection of cholera toxin B subunit (CTB) into a dorsal nerve of the penis] were used. After discrimination of a single neuron responding to penile stimulation, testing for somatovisceral convergence was done (mechanical stimulation of the distal colon and the skin over the entire hindquarters). In 12 rats, a limited number of neurons (43 in total) responded to penile stimulation. Many of these neurons also responded to scrotal stimulation (53.5%, dorsal and/or ventral scrotum) and/or prepuce stimulation (46.5%). Histological reconstruction of the electrode tracks showed that the majority of neurons responding to penile stimulation were located ventrally within the medial one-third of the gracile nucleus surrounding obex. This location corresponded to sparse innervation by CTB-immunoreactive primary afferent terminals. These results indicate that neurons in the gracile nucleus are likely part of the pathway that provides low-threshold penile inputs to MRF, a region known to play an important role in mating processes.
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Affiliation(s)
- Kyle J Cothron
- Department of Anatomical Sciences and Neurobiology, University of Louisville School of Medicine, Louisville, KY 40292, USA
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Damaser MS, Samplaski MK, Parikh M, Lin DL, Rao S, Kerns JM. Time course of neuroanatomical and functional recovery after bilateral pudendal nerve injury in female rats. Am J Physiol Renal Physiol 2007; 293:F1614-21. [PMID: 17728381 PMCID: PMC2528278 DOI: 10.1152/ajprenal.00176.2007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The pudendal nerve innervates the external urethral sphincter (EUS) and is among the tissues injured during childbirth, which may lead to symptoms of stress urinary incontinence (SUI). To understand the mechanisms of injury and repair, urethral leak-point pressure (LPP) was measured 4 days, 2 wk, or 6 wk after bilateral pudendal nerve crush. Morphometric changes in the distal nerve and EUS were examined by light and electron microscopy. To determine whether recovery resulted from pudendal neuroregeneration, LPP was measured before and after pudendal nerve transection 2 wk after nerve crush. LPP was significantly decreased 4 days after pudendal nerve crush compared with sham-injured animals as well as 2 or 6 wk after nerve crush. LPP was not significantly different 2 or 6 wk after nerve crush compared with sham-injured animals, suggesting that urethral function had returned to normal. Four days after pudendal nerve crush, the EUS branch of the pudendal nerve distal to the injury site showed evidence of nerve degeneration and the EUS appeared disrupted. Two weeks after nerve crush, the distal nerve and EUS both showed evidence of both nerve degeneration and recovery. Two weeks after nerve crush, LPP was significantly decreased after nerve transection. Six weeks after nerve injury, evidence of neuroregeneration was observed in the pudendal nerve and the EUS. This study has demonstrated that functional recovery and neuroregeneration are significant 2 wk after nerve crush, although by anatomical assessment, recovery appears incomplete, suggesting that 2 wk represents an early time point of initial neuroregeneration.
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Affiliation(s)
- Margot S Damaser
- Dept. of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation, 9500 Euclid Ave., ND20, Cleveland, OH 44195, USA
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Garcia LI, Soto-Cid A, Carrillo P, Toledo R, Hernandez ME, Manzo J. Characteristics of ejaculated rat semen after lesion of scrotal nerves. Physiol Behav 2007; 91:120-5. [PMID: 17343882 DOI: 10.1016/j.physbeh.2007.01.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2006] [Revised: 01/19/2007] [Accepted: 01/31/2007] [Indexed: 10/23/2022]
Abstract
The scrotum, representing the pouch surrounding the testes and their associated structures, plays a significant role in maintaining the gonad at a temperature lower than that of the body. Although thermoregulation of the testes has been ascribed as a main function of the scrotum, here we found that mechanical stimulation of the scrotum is important during mating to facilitate the appropriate expulsion of semen during ejaculation. Previously we showed that the scrotal skin area is innervated by two nerve branches, the proximal (Psb) and distal (Dsb) scrotal branches which supply the proximal or distal half of the scrotum, respectively. The sensory field of each nerve is testosterone-dependent. The decreased androgen levels following castration reduce the sensitive area to mechanical stimuli that can be restored following exogenous administration of the hormone. Here, we tested the effect of scrotal nerve transection on sexual parameters of experienced male rats. Data show that lesion of PSb or DSb alone or combined did not affect the execution of sexual behavior. However, these lesions significantly reduced the proportion of males that expelled semen during ejaculation, with that semen showing a reduced quantity of sperm. Thus, scrotal nerves are important in reproduction not for the appropriate display of sexual behavior, but for the expulsion of a normal quantity of semen and number of sperm during ejaculation. Our suggestion is that scrotal afferents trigger spinal reflexes to activate autonomic efferents supplying the male reproductive tract for the control of seminal emission.
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Affiliation(s)
- Luis I Garcia
- Instituto de Neuroetología, Universidad Veracruzana, Apartado Postal 566, Xalapa, Ver., 91000, Mexico.
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Peng CW, Chen JJJ, Chang HY, de Groat WC, Cheng CL. External urethral sphincter activity in a rat model of pudendal nerve injury. Neurourol Urodyn 2006; 25:388-96. [PMID: 16637068 DOI: 10.1002/nau.20229] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIMS Pudendal nerve injury in the rat has been a useful animal model for studying stress urinary incontinence (SUI). However, the effect of pudendal nerve injury on activity of the external urethral sphincter (EUS) is relatively unexplored. The aims of this study were to examine voiding and the EUS electromyogram (EMG) in a durable SUI model in rats with bilateral or unilateral pudendal nerve transections. In addition, the effects of denervation on urethral anatomy were investigated. METHODS A leak point pressure (LPP) test was first used to demonstrate that pudendal nerve transection induced SUI. Cystometry exhibited changes in voiding function and EUS-EMG measurements provided a quantitative evaluation of EUS activity during voiding. The morphological changes in sections through the mid-urethra were assessed with hematoxylin and eosin (H&E) staining. RESULTS A significant decrease in average LPP was detected in rats 6 weeks after bilateral pudendal nerve transection (BPNT). Abnormal urodynamic measurements including a decrease in contraction amplitude and voided volume as well as an increase in contraction duration, and residual volume all indicated inefficient voiding. In addition EUS-EMG silent periods were reduced and the frequency of EUS-EMG bursting during voiding was increased. Atrophy of striated muscle in the EUS was also detected in rats with pudendal nerve transection(s). CONCLUSIONS Our results indicate that pudendal nerve transection in rats decreases urethral outlet resistance and causes striated muscle atrophy in the EUS, EUS-EMG abnormalities and inefficient voiding. The results demonstrate that BPNT is a durable model for SUI.
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Affiliation(s)
- Chih-Wei Peng
- Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan, Republic of China
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Lenz KM, Sengelaub DR. Maternal licking influences dendritic development of motoneurons in a sexually dimorphic neuromuscular system. Brain Res 2006; 1092:87-99. [PMID: 16674931 DOI: 10.1016/j.brainres.2006.03.070] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2006] [Revised: 03/21/2006] [Accepted: 03/22/2006] [Indexed: 12/29/2022]
Abstract
Maternal licking of pups' perineal regions affects the development of the spinal nucleus of the bulbocavernosus (SNB), a sexually dimorphic motor nucleus in the lumbar spinal cord that controls penile reflexes involved with copulation. Maternal licking influences SNB motoneuron number, with reductions in licking resulting in fewer motoneurons. Reduced maternal licking also has functional consequences in adulthood, resulting in increased latency to ejaculation and postejaculatory intromission and longer interintromission intervals. In this experiment, we assessed the potential effect of maternal licking on the development of SNB dendritic morphology. To reduce maternal licking, dams were treated with intranasal application of zinc sulfate during the first two postnatal weeks, which interferes with their ability to detect the pup odors that drive the licking behavior. At either postnatal day (P) 28 (when SNB dendritic length is normally maximal) or P49 (when SNB dendritic morphology is normally mature), SNB motoneurons were retrogradely labeled with cholera toxin-conjugated HRP, and dendritic arbor was reconstructed in three dimensions. At P28, the dendritic arbor of reduced maternal licking pups was not different from controls; however at P49, reduced licking pups showed a 23% reduction in dendritic arbor in the SNB, an effect that was especially pronounced in the rostral end of the nucleus, where reductions reached 48%. These results suggest that reductions in perineal stimulation provided by maternal licking could affect adult male copulatory behavior via alterations in SNB motoneuron morphology, and thus support maternal licking as an important factor in normal neural and behavioral development.
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Affiliation(s)
- Kathryn M Lenz
- Department of Psychological and Brain Sciences and Program in Neuroscience, 1101 E. 10th Street, Indiana University, Bloomington, IN 47405, USA
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Nout YS, Leedy GM, Beattie MS, Bresnahan JC. Alterations in eliminative and sexual reflexes after spinal cord injury: defecatory function and development of spasticity in pelvic floor musculature. PROGRESS IN BRAIN RESEARCH 2006; 152:359-72. [PMID: 16198713 DOI: 10.1016/s0079-6123(05)52024-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Spinal cord injury often results in loss of normal eliminative and sexual functions. This chapter is focused on defecatory function, although aspects of micturition and erectile function will be covered as well due to the overlap in anatomical organization and response to injury. These systems have both autonomic and somatic components, and are organized in the thoracolumbar (sympathetic), lumbosacral (somatic), and sacral (parasympathetic) spinal cord. Loss of supraspinal descending control and plasticity-mediated alterations at the level of the spinal cord, result in loss of voluntary control and in abnormal functioning of these systems including the development of dyssynergies and spasticity. There are several useful models of spinal cord injury in rodents that exhibit many of the autonomic dysfunctions observed after spinal cord injury in humans. Numerous studies involving these animal models have demonstrated development of abnormalities in bladder, external anal sphincter, and erectile function, such as detrusor-sphincter-dyssynergia and external anal sphincter hyperreflexia. Here we review many of these studies and show some of the anatomical alterations that develop within the spinal cord during the development of these hyperreflexias. Furthermore, we show that spasticity develops in other pelvic floor musculature as well, such as the bulbospongiosus muscle, which results in increased duration and magnitude of pressures developed during erectile events and increased duration of micturition. Advances and continued improvement in the use of current animal models of spinal cord injury should encourage and increase the laboratory work devoted to this relatively neglected area of experimental spinal cord injury.
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Affiliation(s)
- Yvette S Nout
- Department of Neuroscience, Laboratory of CNS Repair and Spinal Trauma and Repair Laboratories, The Ohio State University College of Medicine and Public Health, Columbus, OH, USA
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Hubscher CH. Ascending spinal pathways from sexual organs: effects of chronic spinal lesions. AUTONOMIC DYSFUNCTION AFTER SPINAL CORD INJURY 2006; 152:401-14. [PMID: 16198716 DOI: 10.1016/s0079-6123(05)52027-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
A recent survey of paraplegics indicates that regaining sexual function is of the highest priority for both males and females (Anderson, K.D. (2004) Targeting recovery: priorities of the spinal cord-injured population J. Newrotrauma, 21: 1371-1383). Our understanding of the neural pathways and mechanisms underlying sexual behavior and function is limited at the present time. More studies are obviously needed to direct experiments geared toward developing effective therapeutic interventions. In this chapter, a review of studies on the processing of sensory inputs from the male and female reproductive organs is presented with a review of what is known about the location of ascending spinal pathways conveying this information. The effect of spinal cord injury on sexual function and the problems that ensue are discussed.
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Affiliation(s)
- Charles H Hubscher
- Department of Anatomical Sciences and Neurobiology, University of Louisville School of Medicine, Louisville, KY 40292, USA.
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Cruz Y, Downie JW. Abdominal muscle activity during voiding in female rats with normal or irritated bladder. Am J Physiol Regul Integr Comp Physiol 2005; 290:R1436-45. [PMID: 16373437 DOI: 10.1152/ajpregu.00556.2005] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aims of the present study were to determine in female rats whether abdominal muscle discharges during normal voiding and to describe the effect of bladder irritation on this visceromotor activity. The sensory pathway of this reflex was also determined. Electromyograms (EMGs) indicated that in awake rats, the abdominal muscle was consistently activated during spontaneous voiding and during voiding induced by saline infusion. Similarly, in anesthetized animals, the muscle discharged during urine expulsion. The abdominal EMG activity was not abolished by hypogastric (Hgnx) or sensory pudendal neurectomy (SPdnx). SPdnx dramatically decreased the intercontraction interval and voided volume. Acetic acid infusion reduced the intercontraction interval and increased bladder contraction duration. It also reduced the pressure threshold for evoking the abdominal EMG response and increased the EMG duration and amplitude. Although SPdnx and Hgnx modified some urodynamic parameters, they did not reverse the acetic acid effect on EMG activity. Thus the afferents activating the visceromotor reflex during normal voiding and the increased reflex in response to acetic acid are probably both carried by the pelvic nerve. Abdominal muscle activity induced by bladder distension has been considered to be a pain marker. However, we conclude that in female rats, the abdominal muscle is reflexively activated during physiological urine expulsion. On the other hand, bladder irritation is marked by an exaggeration of this abdominal visceromotor reflex.
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Affiliation(s)
- Yolanda Cruz
- Dept. of Pharmacology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada B3H 1X5
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Chang HY, Cheng CL, Chen JJJ, Peng CW, de Groat WC. Reflexes evoked by electrical stimulation of afferent axons in the pudendal nerve under empty and distended bladder conditions in urethane-anesthetized rats. J Neurosci Methods 2005; 150:80-9. [PMID: 16039722 PMCID: PMC3119341 DOI: 10.1016/j.jneumeth.2005.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2005] [Revised: 05/27/2005] [Accepted: 06/01/2005] [Indexed: 10/25/2022]
Abstract
This study examined reflex mechanisms that mediate urinary bladder and external urethral sphincter (EUS) coordination in female Sprague-Dawley urethane-anesthetized rats under empty and distended bladder conditions. The bladder was distended either by a small balloon or a saline filled catheter inserted through the body of the bladder. Stimulation of the entire pudendal nerve elicited short latency (8-12 ms) responses in the EUS and short (3-8 ms) and long latency responses (16-20 ms) in contralateral pudendal nerve. The long latency pudendal-pudendal reflex was reduced by 36.7% in area during bladder distension with the balloon catheter. However, there was no significant change in the area of pudendal-EUS reflex during bladder distension. Peak amplitudes of both reflexes were reduced 32% by bladder distension. The effects of glutamatergic receptor antagonists on the reflexes were also examined. MK 801 (0.3-5mg/kg, i.v.), an N-methyl-d-aspartate glutamatergic receptor antagonist, markedly depressed the pudendal-pudendal reflex, but LY 215490 (3mg/kg, i.v.), an alpha-amino-5-methyl isoxazole-4-propionate antagonist, had a minimal inhibitory effect. Both glutamatergic receptor antagonists significantly suppressed the pudendal-EUS reflex. These results indicate that the EUS is innervated by multiple pathways and that glutamatergic excitatory transmission is important in the neural mechanisms underlying bladder-sphincter coordination in the rat.
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Affiliation(s)
- Hui-Yi Chang
- Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
- Department of Pharmacology, University of Pittsburgh School of Medicine, Pennsylvania, USA
| | - Chen-Li Cheng
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jia-Jin J. Chen
- Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
- Corresponding author. Tel.: +886 6 2757575x63423. (J.-J.J. Chen)
| | - Chi-Wei Peng
- Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - William C. de Groat
- Department of Pharmacology, University of Pittsburgh School of Medicine, Pennsylvania, USA
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Cruz Y, Downie JW. Sexually dimorphic micturition in rats: relationship of perineal muscle activity to voiding pattern. Am J Physiol Regul Integr Comp Physiol 2005; 289:R1307-18. [PMID: 15994373 DOI: 10.1152/ajpregu.00088.2005] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In the present study we examined the possibility that striated muscle activity may underlie sexually dimorphic micturition in rats. Micturition dynamics, the gross anatomy of the external urethral sphincter, and the participation of the striated perineal muscles in micturition were compared in urethane-anesthetized adult male and female rats. Bladder contraction characteristics, particularly the magnitude of bladder high-frequency pressure waves during voiding, differed between sexes. Dissections indicated that the sphincter was more extensive and thicker in males than in females. Electromyography showed that in both sexes the sphincter discharged in bursts that correlated with the rising phase of high-frequency bladder pressure oscillations. Regional differences in discharge pattern were seen in the sphincters of males, with the proximal part of the sphincter showing components activated during bladder filling. Bulbospongiosus, ischiocavernosus, and cremaster muscles also were activated during bladder contraction in males. In both sexes transection of the motor branch of the lumbosacral plexus eliminated the bladder high-frequency oscillations and reduced voided volume. Neurectomy did not affect bladder pressure but reduced voiding efficiency by 45% in males. In females the bladder pressure was dramatically decreased, but voiding efficiency only decreased by 24%. Our findings suggest that, in rats, striated perineal muscles contribute to the sexually dimorphic micturition. Activity of the dimorphic perineal muscles may regulate genital and urinary urethra expulsive functions, helping to expel seminal plug and fluids through the long urethra in the male.
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Affiliation(s)
- Yolanda Cruz
- Department of Pharmacology, Faculty of Medicine, Dalhousie Uiversity, Halifax, Nova Scotia, Canada
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Cruz Y, Zempoalteca R, Angelica Lucio R, Pacheco P, Hudson R, Martínez-Gómez M. Pattern of sensory innervation of the perineal skin in the female rat. Brain Res 2004; 1024:97-103. [PMID: 15451370 DOI: 10.1016/j.brainres.2004.07.046] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2004] [Indexed: 11/27/2022]
Abstract
Here we describe the nerves innervating the perineal skin together with their sensory fields in the adult female rat. Electrophysiological recording showed that the lumbosacral and L6-S1 trunks, in part by way of the sacral plexus, transmit sensory information from the perineal skin via four nerves: the viscerocutaneous branch of the pelvic nerve innervating the skin at the midline between the vaginal opening and anus, the sensory branch of the pudendal nerve innervating the clitoral sheath, the distal perineal branch of the pudendal nerve innervating a broad area of skin adjacent to the vaginal opening and anus, and the proximal perineal branch of the sacral plexus innervating a broad area of skin adjacent to the clitoris and vaginal opening. The sensory fields of three of these nerves overlapped to some degree: the viscerocutaneous branch of the pelvic and the distal perineal branch of the pudendal nerves at the midline skin between the vaginal opening and the anus, and the distal perineal branch of the pudendal nerve and the proximal perineal branch of the sacral plexus at the skin lateral to the vaginal opening. Such overlap might provide a safeguard helping to ensure that somatosensory input from the perineal region important for triggering reproductive and nonreproductive reflexes reaches the CNS.
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Affiliation(s)
- Yolanda Cruz
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Apartado Postal No. 262 Tlaxcala, Tlax, México
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RE: FUNCTIONAL AND NEUROANATOMICAL EFFECTS OF VAGINAL DISTENTION AND PUDENDAL NERVE CRUSH IN THE FEMALE RAT: Reply by Authors. J Urol 2004. [DOI: 10.1016/s0022-5347(05)62197-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Osmonov DK, Portillo FJM. RE: FUNCTIONAL AND NEUROANATOMICAL EFFECTS OF VAGINAL DISTENTION AND PUDENDAL NERVE CRUSH IN THE FEMALE RAT. J Urol 2004; 171:2388; author reply 2388-9. [PMID: 15126851 DOI: 10.1097/01.ju.0000124910.40356.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Martinez Portillo FJ, Osmonov DK, Seif C, Braun PM, Boehler G, Alken P, Juenemann KP. RESTORATION OF EXTERNAL URETHRAL SPHINCTER FUNCTION AFTER PUDENDAL NERVE END-TO-END ANASTOMOSIS IN THE MALE RABBIT. J Urol 2004; 171:1715-9. [PMID: 15017272 DOI: 10.1097/01.ju.0000116124.58457.b4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE In this study we rehabilitated external urethral sphincter function by pudendal nerve end-to-end anastomosis after experimental pudendal nerve axotomy in male rabbits. MATERIALS AND METHODS A total of 17 animals were included in this study, including group 1-a control group of 5 (29.4%), group 2-6 (35.3%) and group 3-6 (35.3%). Animals from group 2 underwent bilateral axotomy and group 3 underwent pudendal nerve end-to-end anastomosis. In all groups we performed urodynamic investigations prior to axotomy, after axotomy or anastomosis, and 14, 42 and 90 days after axotomy or nerve anastomosis. RESULTS In untreated group 1 control sphincter pressure was 28.5 cm H2O. In group 2 average urethral sphincter pressure was 5.6 cm H2O 14 days after axotomy with only a slight increase to 11.05 cm H2O by day 90. In group 3 external urethral pressure increased to 8.26 cm H2O after 14 days and to 21.32 cm H2O by postoperative day 90. CONCLUSIONS External urethral sphincter deficiency after bilateral pudendal nerve axotomy demonstrates the primacy of the pudendal nerve in the innervation of the external urethral sphincter. We were able to rehabilitate external urethral sphincter function by performing pudendal nerve end-to-end anastomosis.
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Affiliation(s)
- Francisco J Martinez Portillo
- Department of Urology, University Hospital Schleswig-Holstein (Campus Kiel), Christian-Albrechts-University of Kiel, Heidelberg, Germany.
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Bremer RE, Barber MD, Coates KW, Dolber PC, Thor KB. Innervation of the levator ani and coccygeus muscles of the female rat. ACTA ACUST UNITED AC 2003; 275:1031-41. [PMID: 14533177 DOI: 10.1002/ar.a.10116] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
In humans, the pelvic floor skeletal muscles support the viscera. Damage to innervation of these muscles during parturition may contribute to pelvic organ prolapse and urinary incontinence. Unfortunately, animal models that are suitable for studying parturition-induced pelvic floor neuropathy and its treatment are rare. The present study describes the intrapelvic skeletal muscles (i.e., the iliocaudalis, pubocaudalis, and coccygeus) and their innervation in the rat to assess its usefulness as a model for studies of pelvic floor nerve damage and repair. Dissection of rat intrapelvic skeletal muscles demonstrated a general similarity with human pelvic floor muscles. Innervation of the iliocaudalis and pubocaudalis muscles (which together constitute the levator ani muscles) was provided by a nerve (the "levator ani nerve") that entered the pelvic cavity alongside the pelvic nerve, and then branched and penetrated the ventromedial (i.e., intrapelvic) surface of these muscles. Innervation of the rat coccygeus muscle (the "coccygeal nerve") was derived from two adjacent branches of the L6-S1 trunk that penetrated the muscle on its rostral edge. Acetylcholinesterase staining revealed a single motor endplate zone in each muscle, closely adjacent to the point of nerve penetration. Transection of the levator ani or coccygeal nerves (with a 2-week survival time) reduced muscle mass and myocyte diameter in the iliocaudalis and pubocaudalis or coccygeus muscles, respectively. The pudendal nerve did not innervate the intrapelvic skeletal muscles. We conclude that the intrapelvic skeletal muscles in the rat are similar to those described in our previous studies of humans and that they have a distinct innervation with no contribution from the pudendal nerve.
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Affiliation(s)
- Ronald E Bremer
- Research Services, Veterans Affairs Medical Center, Durham, North Carolina., USA
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Manzo J, García LI, Camacho MA, Hernández ME, Pacheco P. Influence of testosterone on the electrical properties of scrotal nerves at the cutaneous and spinal levels in the male rat. J Peripher Nerv Syst 2003; 8:75-81. [PMID: 12795711 DOI: 10.1046/j.1529-8027.2003.03010.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The scrotal nerves in the rat were studied electrophysiologically to describe their topographic organization in the skin and in the dorsal roots, and to determine if the electrical properties of these afferents are under the influence of testosterone. There are 2 afferent nerve branches innervating this area, the proximal scrotal branch supplying the proximal half of the scrotum (PSb), and the distal scrotal branch supplying the distal half (DSb). Results showed that afferent axons from PSb enter the spinal cord through the L5 and L6 dorsal roots, and axons from DSb enter the cord through the L6 and S1 dorsal roots. Mechanical stimulation of the scrotal skin exposed 3 dermatome areas, the L5, L6, and S1, with L6 being the longest dermatome with intermingled terminals from PSb and DSb. Decreased levels of testosterone after castration increased the threshold to trigger the activity of scrotal afferents, and the exogenous administration of the hormone reverted it. This effect was similar in the dorsal penile nerve. The decrease in androgen levels produced a reduction in the skin sensory field to mechanical stimuli that was restored after the administration of the hormone. As the scrotal nerves are highly stimulated during copulation in parallel with the dorsal penile nerve, it is suggested that the sensory field of the scrotal skin could be closely related to the modifications in sexual behavior after testosterone manipulation.
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Affiliation(s)
- Jorge Manzo
- Instituto de Neuroetología, Universidad Veracruzana, Xalapa, Veracruz 91001, Mexico.
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Zempoalteca R, Martínez-Gómez M, Hudson R, Cruz Y, Lucio RA. An anatomical and electrophysiological study of the genitofemoral nerve and some of its targets in the male rat. J Anat 2002; 201:493-505. [PMID: 12489761 PMCID: PMC1570986 DOI: 10.1046/j.1469-7580.2002.00112.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2002] [Indexed: 01/10/2023] Open
Abstract
Anatomical descriptions of the genitofemoral nerve (GFn) innervating the lower pelvic area are contradictory. Here we re-examine its origin and innervation by its various branches of principal target organs in the male rat. Using gross dissection, electrophysiological techniques and retrograde tracing of motoneurones with horseradish peroxidase, we confirm that the GFn originates from lumbar spinal nerves 1 and 2, and that at the level of the common iliac artery it divides into a lateral femoral and a medial genital branch. In contrast to previous studies, we report that the genital and not the femoral branch innervates the abdominal-inguinal skin, and not only the genital but also the femoral branch innervates the cremaster muscle (Cm) surrounding the testes. Motoneurones innervating the Cm proper are located in the ventral nucleus of L1 and L2, and those innervating the muscular transition region of the rostral Cm are located in the ventral nucleus in L1 and the ventrolateral nucleus in L2. The GFn may contribute to male reproductive performance by transmitting cutaneous information during copulation and, via contraction of the Cm to promote ejaculation, the protective displacement of the testes into the abdominal cavity during fighting and as a sperm-protecting thermoregulatory measure.
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Affiliation(s)
| | - Margarita Martínez-Gómez
- Centre for Physiological Research, University of TlaxcalaMexico
- Institute of Biomedical Research, National University of MexicoMexico
| | - Robyn Hudson
- Institute of Biomedical Research, National University of MexicoMexico
| | - Yolanda Cruz
- Centre for Physiological Research, University of TlaxcalaMexico
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KONTANI HITOSHI, SHIRAOYA CHISATO. Sex difference in urethral response to electrical stimulation of efferent nerves in the pudendal sensory branch of rats. Int J Urol 2002. [DOI: 10.1046/j.1442-2042.2002.00523.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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