1999 Fiscal Year Final Research Report Summary
Reconstruction of injured autonomic nerves in the abdominal and pelvic spaces.
| Project/Area Number |
09470341
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Urology
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| Research Institution | Tokyo Medical and Dental University |
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Principal Investigator |
KIHARA Kazunori Tokyo Med. & Dent. Univ., School of Medicine, Associate Professor, 医学部, 助教授 (40161541)
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| Co-Investigator(Kenkyū-buntansha) |
KAGEYAMA Yukio Tokyo Med. & Dent. Univ., School of Medicine, Assistant Professor, 医学部, 助手 (10211153)
ISHIZAKA Kazuhiro Tokyo Med. & Dent. Univ., School of Medicine, Assistant Professor, 医学部, 助手 (60168218)
SATO Kenji Tokyo Med. & Dent. Univ., School of Allied Health Sciences, Professor, 医学部, 教授 (20107246)
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| Project Period (FY) |
1997 – 1999
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| Keywords | Autonomic nerve / Reconstruction / Sexual function / Voiding function |
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| Research Abstract |
1) Spontaneous reconstruction of the hypogastric nerve : Four years after partial removal (2.5 cm) of the canine hypogastric nerve, stimulation of the lumbar splanchnic nerve (LSN) generated contractions of the vas deferens, bladder neck and prostate. The multiple crossed pathways from the LSN to the target organs were also demonstrated to be reconstructed spontaneously.
2) Reattachment of the transected autonomic nerves :
(1) Eighteen months after reattachment of transected canine hypogastric nerve : stimulation of the LSN elicited contractions of the vas deferens, bladder neck and prostate. The multiple crossed pathways from the LSN to the target organs were demonstrated to be reconstructed. The rate of reconstruction by reattachment was higher than that without reattachment.
(2) After reattachment of transected pelvic nerve at its distal end, stimulation of its proximal end generated bladder contraction. The capacity was sufficient and residual urine was little.
(3) Auto-transplantation of the bladder accompanied with pelvic nerve reattachment succeeded. The capacity was sufficient, residual urine little, and voiding reflex was preserved. Our results indicated that reconstruction of the transected pelvic nerve occurs within 9 months after reattachment.
3) Autonomic nerve graft : After grafting the hypogastric nerve or the genitofemoral nerve into the defect of the pelvic nerve, stimulation of the pelvic nerve elicited bladder contraction. The capacity was sufficient and residual urine was little.
4) Autonomic nerve-transfer : After anastomosis of the hypogastric nerve with the pelvic nerve, the pathway from the spinal cord, passing through the LSN, hypogastric nerve, pelvic nerve and pelvic plexus to the intrapelvic target organs were constructed.
5) Histological study of the nerve at the site reattached demonstrated regeneration of the autonomic nerve.
6) Nerve graft was clinically applied in retroperitoneal sympathetic nervous system. The result was promising.
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