Abstract
The striated sphincter of the male urethra, the so-called rhabdosphincter, contributes significantly to urethral closure pressure. It is generally agreed that the somatic nerve fibers from the pudendal nerve innervate the rhabdosphincter, and the autonomic nerve fibers innervate the smooth muscle of the urethra. Although it is difficult to clearly identify the rhabdosphincter macroscopically, we minutely investigated the nerve branches to the urethral sphincter muscle region in 10 male pelvic halves. In addition, the origins and courses of the pudendal plexus in 88 male pelvic halves were investigated. To this region were given branches of the pudendal nerve and the pelvic plexus. The branches from the pelvic plexus to the region generally originated from S4 as the lowest branch of the pelvic splanchnic nerve, and ran along the rectal attachment of the levator ani. The caudal root of the pelvic splanchnic nerve formed a common trunk with the nerve to the levator ani (94%). Various connections were sometimes observed between the pudendal nerve and the branches medial to the levator ani. It is suggested that the somatic nerve fibers from the nerve to the levator ani or from the pudendal nerve might also join the nerve branches to the region from the pelvic plexus.
Résumé
Le sphincter strié de l'urètre de l'homme, aussi appelé rhabdosphincter, contribue significativement a la pression de clôture de l'urètre. Il est généralement admis que les fibres somatiques du nerf pudendal innervent le sphincter strié, et que les fibres nerveuses autonomes innervent le muscle lisse de l'urètre. Ben qu'il soit difficile d'identifier macroscopiquement le sphincter strié, nous avons observé microscopiquement les branches nerveuses destinées aux muscle sphincter urétral sur dix hémi-pelvis masculins. De plus, l'origine et le trajet du plexus pudendal ont été explorés sur 88 hémi-pelvis masculins. Cette région recevait des branches du nerf pudendal et du plexus pelvien. Les branches du plexus pelvien pour cette zone provenaient en général de S4, sous la forme de la branche la plus distale du nerf splanchnique pelvien, et cheminaient le long de l'insertion rectale du muscle élévateur de l'anus. La racine caudale du nerf splanchnique pelvien formait un tronc commun avec le nerf du muscle élévateur de l'anus (94%). Des connexions variables ont parfois été observées entre le nerf pudendal et les branches médiales au muscle élévateur de l'anus. Ceci suggère que les fibres nerveuses somatiques du nerf du muscle élévateur de l'anus ou du nerf pudendal puissent rejoindre les branches nerveuses provenant du plexus pelvien.
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References
Akita K, Sakamoto H, Sato T (1995) Muscles of the pelvic outlet in the rhesus monkey (Macaca mulatta) with special reference to nerve supply. Anat Rec 241: 273–283
Burnett AL, Mostwin JL (1998) In situ anatomical study of the male urethral sphincteric complex: relevance to continence preservation following major pelvic surgery. J Urol 160: 1301–1306
Colleselli K, Poisel S, Schachtner W, Bartsch G (1990) Nerve-preserving bilateral retroperitoneal lymphadenectomy: anatomical study and operative approach. J Urol 144: 293-297
Colleselli K, Stenzl A, Eder R, Strasser H, Poisel S, Bartsch G (1998) The female urethral sphincter: a morphological and topographical study. J Urol 160: 49–54
Dorschner W, Biesold M, Stolzenburg JU (1999) The dispute about the external sphincter and the urogenital diaphragm. J Urol 162: 1942–1945
Dorschner W, Stolzenburg JU, Neuhaus J (2001) Structure and function of the bladder neck. Adv Anat Embryol Cell Biol 159: 1-109
Fletcher TF, Bradley WE (1978) Neuroanatomy of the bladder-urethra. J Urol 119: 153–160
Gosling JA, Dixon JS, Critchley HO, Thompson SA (1981) A comparative study of the human external sphincter and periurethral levator ani muscles. Br J Urol 53: 35–41
Hayek H (1960) Das Faserkaliber in den Mm. transversus perinei und Sphincter urethrae. Z Anat Entwickl Gesch 121: 455–458
Hayek H (1962) Zur Anatomie des Sphincter urethrae. Z Anat Entwickl Gesch 123: 121-125
Juenemann KP, Lue TF, Schmidt RA, Tanagho EA (1988) Clinical significance of sacral and pudendal nerve anatomy. J Urol 139: 74–80
Kikuchi T (1987) A macroscopical observation of the nerves to the pelvic floor muscles, the obturator internus and the quadratus femoris. Sapporo Med J 56: 319–332
Kikuchi T (1987) A macroscopical observation of the nerves to the pelvic floor muscles, the obturator internus and the quadratus femoris in some mammals. Hokkaido J Med Sci 62: 96–107
Koyanagi T, Tsuji I (1977) The mechanism of urinary continence after prostatectomy. Urol Int 32: 353–367
Kokoua A, Homsy Y, Lavigne JF, Williot P, Corcos J, Laberge I, Michaud J (1993) Maturation of the external urinary sphincter: a comparative histotopographic study in humans. J Urol 150: 617–622
Krahn HP, Morales PA (1965) The effect of pudendal nerve anaesthesia on urinary continence after prostatectomy. J Urol 94: 282–285
Murakami G, Nakajima F, Sato TJ, Tsugane MH, Taguchi K, Tsukamoto T (2002) Individual variations in aging of the male urethral rhabdosphincter in Japanese. Clin Anat 15: 241–252
Nakanishi T (1967) Studies on the pudendal nerve. 1: A macroscopical observation of the pudendal nerve in man. Acta Anat Nippon 42: 223–239
Nakanishi T (1967) Macroscopical observations on the muscular branches of the pudendal plexus. Acta Anat Nippon 42: 288–295
O'Donnell P, Finans BF (1989) Continence following nerve-sparing radical prostatectomy. J Urol 142: 1227–1229
Oelrich TM (1980) The urethral sphincter muscle in the male. Am J Anat 158: 229–246
Sato K (1980) A morphological analysis of the nerve supply of the sphincter ani externus, levator ani and coccygeus. Acta Anat Nippon 55: 187–223 (in Japanese with English abstract)
Sato K, Sato T (1987) An anatomical investigation on the muscles of the pelvic outlet in crab-eating monkey (Macaca irus) and Japanese monkey (Macaca fuscata) with special reference to their nerve supply. Anat Anz 163: 425–438
Shafik A, Doss S (1999) Surgical anatomy of the somatic terminal innervation to anal urethral sphincters: role in anal and urethral surgery. J Urol 161: 85–89
Steiner MS (2000) Anatomic basis for the continence-preserving radical retropubic prostatectomy. Semin Urol Oncol 18: 9-18
Stolzenburg JU, Schwalenberg T, Do M, Dorschner W, Salomon FV, Jurina K, Neuhaus J (2002) Is the male dog comparable to human? A histological study of the muscle systems of the lower urinary tract. Anat Histol Embryol 31: 198–205
Strasser H, Klima G, Poisel S, Horninger W, Bartsch G (1996) Anatomy and innervation of the rhabdosphincter of the male urethra. Prostate 28: 24–31
Strasser H, Ninkovic M, Hess M, Bartsch G, Stenzl A (2000) Anatomical and functional studies of the male and female urethral sphincter. World J Urol 18: 324–329
Takahashi M (1980) Morphological analysis of the pudendal nerve. Acta Anat Nippon 55: 23–44 (in Japanese with English abstract)
Takahashi M, Sato T (1985) Innervation of the anterior perineal muscles and its morphological consideration. Anat Anz 158: 65–78
Tanagho EA, Schmidt RA, De Araujo CG (1982) Urinary striated sphincter: What is its nerve supply? Urology 20: 415–417
Walsh PC, Leoir H, Eggleston JC (1983) Radical prostatectomy with preservation of sexual function: anatomical and pathological consideration. Prostate 4: 473–485
Walsh PC, Quinlan DM, Morton RA, Steiner MS (1990) Radical retropubic prostatectomy: improved anastomosis and urinary continence. Urol Clin North Am 17: 679–684
Acknowledgement
This study was partly supported by Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports Science and Technology (no. 13671639).
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Akita, K., Sakamoto, H. & Sato, T. Origins and courses of the nervous branches to the male urethral sphincter. Surg Radiol Anat 25, 387–392 (2003). https://doi.org/10.1007/s00276-003-0151-9
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DOI: https://doi.org/10.1007/s00276-003-0151-9