Origins and courses of the nervous branches to the male urethral sphincter |
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Authors: | Akita K Sakamoto H Sato T |
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Affiliation: | (1) Unit of Clinical Anatomy, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8519 Tokyo, Japan |
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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. Electronic Supplementary Material The french version of this article is available in the form of electronic supplementary material and can be obtained by using the Springer Link server located at .
Origine et trajet des branches nerveuses destinées au sphincter uréthral de l'homme 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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Keywords: | Rhabdosphincter Male urethra Pelvic plexus Pelvic splanchnic nerve Nerve to levator ani |
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