Association between sphincter fatigue and urinary incontinence

Research Project

Project/Area Number	16K11049
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Urology
Research Institution	Tottori University
Principal Investigator	MURAOKA Kuniyasu 鳥取大学, 医学部附属病院, 研究員 (20346365)
Co-Investigator(Kenkyū-buntansha)	武中篤鳥取大学, 医学部, 教授 (50368669) 本田正史鳥取大学, 医学部, 准教授 (20362890)
Project Period (FY)	2016-04-01 – 2019-03-31
Project Status	Completed (Fiscal Year 2018)
Budget Amount *help	¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000) Fiscal Year 2018: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000) Fiscal Year 2017: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000) Fiscal Year 2016: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Keywords	外尿道括約筋 / 尿禁制 / 膀胱 / 前立腺 / 直腸 / 精嚢 / 括約筋疲労 / 生理学
Outline of Final Research Achievements	This study aimed to investigate the immunohistochemical features of sympathetic and parasympathetic nerves in the pelvic autonomic plexus branches. The detailed topohistology of nerve fibers at and around the bladder, seminal vesicle, prostate, and rectum was examined. Neuronal nitric oxide synthase (nNOS) and vasoactive intestinal polypeptide (VIP) were used as parasympathetic nerve markers; tyrosine hydroxylase (TH) was used as sympathetic nerve marker. The nerves of the pelvic plexus branches were clearly classified into nerves around the bladder and seminal vesicle (VIP-negative) and nerves around the prostate (VIP-positive). Although nNOS- and VIP-positive nerve fibers are candidate cavernous nerves, cavernous nerve identify cannot be definitively concluded for these nerves in the periprostatic region.
Academic Significance and Societal Importance of the Research Achievements	前立腺癌に対する前立腺全摘除術は標準治療である。しかし、術後の尿失禁および性機能障害が問題となる。従来、前立腺全摘除術では性機能温存を目的に前立腺外側の神経血管束を温存する神経温存術式が行われている。本研究課題で得られた知見で、この神経血管束の中には勃起に関わる神経のみではなく、尿禁制を維持する機能を有する外尿道括約筋に関係した神経も走行している可能性があることが示唆された。この事は前立腺全摘除術後に尿失禁が発症する機序を詳細に明らかにする上で重要な知見であると考えている。