Study of the sympathetic pathway controlling penile detumescence

Ⅰ.消肿1）控制消肿的交感神经通路的鉴定当刺激盆神经时观察到消肿。刺激腰骶交感神经干或精索神经没有引起明显的抑制海绵体压力。2)切断交感神经通路对消肿的影响在双侧腹下神经部分切除的犬中，未观察到消肿障碍，如阴茎异常勃起。用手刺激阴茎引起的勃起在刺激结束后立即出现消肿。在双侧腹下神经和腰骶交感神经干均横断的犬中获得了类似的结果。3)代偿通路切断双侧腹下神经后，腰骶交感干未出现代偿功能。4)内脏大神经-肾上腺髓质系统在消肿中的作用刺激内脏大神经可使肾上腺髓质分泌组织胺，引起消肿。5)盆神经的重建盆神经的切断和立即复位保留了其对阴茎的功能。Ⅱ.腹下神经的功能与重建1）经腹下神经支配精道的交感神经通路主要来源于L2和L3腰内脏神经，这些腰内脏神经起源于L1和L2脊段。2)自主神经的分化在从腰内脏神经到精道的每一条主要和代偿性通路上都取得了进展。3)腹下神经切断后立即重接可恢复其对精道的功能，并保留其交叉神经支配机制。

I.Detumescence1) Identification of the sympathetic nerve pathway controlling detumescence Detumescence was observed when the pelvic nerve was stimulated. Stimulation of the lumbosacral sympathetic trunk or the spermatic nerve did not elicit apparent inhibition of cavernous pressure. 2) Effect of transection of the sympathetic nerve pathway to detumescence I n dogs that underwent partial resection of the hypogastric nerve bilaterally, disturbance of detumescence, such as priapism, was not observed. Erection induced by manual penile stimulation showed detumescence immediately after finishing the stimulation. Similar results were obtained in dogs that underwent transection of both the hypogastric nerve and the lumbosacral sympathetic trunk bilaterally. 3) Compensatory pathway Compensatory function of the lumbosacral sympathetic trunk was not found after transecting the hypogastric nerve bilaterally. 4) Effect of major sp1anchnic nerve-adrenal medulla system to detumescence Stimulation of the major splanchnic nerve caused secretion of cathecolamine from adrenal medulla and elicited detumescence. 5) Reconstruction of the pelvic nerve Transection and immediate reattachment of the pelvic nerve preserved its function to the penis. Interposition of the hypogastric nerve between the transected pelvic nerves also preserved its function.II.Function and reconstruction of the hypogastric nerve1) The sympathetic pathway which controls seminal tract via the hypogastric nerve mostly originates from L2 and L3 lumbar splanchnic nerves, which originate from L1 and L2 spinal segments. 2) Differentiation of the autonomic nerve is making progress in each of the main and compensatory pathways from the lumbar splanchnic nerve to the seminal tract. 3) Transection and immediate reattachment of the hypogastric nerve can restore its function to the seminal tract and preserve its cross-innervation mechanism.