Study of the mechanism of spermtransport and nerve control, and its clinical application

在哺乳动物中，从腰内脏神经通过腹下神经到达输精管的神经通路通过双交叉神经系统控制精子通过输精管的运输。两个交叉点是肠系膜下神经丛(人的腹下上神经丛)和双侧盆腔神经丛之间的连合支。我们发现，刺激盆腔神经不会引起完整动物血管压力的升高，但在切断双侧腹下神经后，能够引起血管压力的升高。有两种机制可以解释这一现象，一种是由起源于腰骶交感神经干的盆神经所含的交感神经通路代偿，另一种是盆神经中的节前神经元萌发到盆丛的腹下神经中的节后神经元。Ho…通过内脏大神经-肾上腺髓质系统更合理地控制精子的运输被高度怀疑。II.精子通过输精管运输的机制。直接电刺激附睾尾和输精管的任何部位只在附睾尾引起管腔内压力升高，而刺激睾丸、附睾头和附睾体则不引起反应。在刺激过程中，注入附睾尾的染料被释放到尿路中。刺激停止后不久，输精管中残留染料的逆行运动导致其最终重新进入附睾尾部。扩张的血管壁只在扩张的部位产生腔内压力的升高。上述结果表明，犬精子存在快速顺行和逆行运动，附睾尾部在精子运输中起重要作用。III.自主神经吻合。切断输精管、膀胱颈和前列腺后，精管功能得到恢复。IV.一种新的犬精液产生方法及其在男性中的应用：直接电刺激输精管，刺激从射精口和活动精子排出精液的患者输精管。较少

I.Autonomic nervous system controlling sperm transport through the vas deferens.In mammalians the nerve pathway from the lumbar splanchnic nerve (L_<2-5>) to the vas deferens via the hypogastric nerve controls sperm transport through the vas with double cross-innervation system. The two crossing points were the inferior mesenteric plexus (superior hypogastric plexus in human) and the commissural branches between bilateral pelvic plexuses. We found that stimulation of the pelvic nerve which does not elicit elevation of vasal pressure in intact animals is able to elicit elevation of vasal pressure after transection of the hypogastric nerve bilaterally. Two mechanisms to explain this phenomenon were found ; one is compensation by the sympathetic nerve pathway included in the pelvic nerve originated from the lumbo-sacral sympathetic trunk and the other is sprouting of the preganglionic neuron in the pelvic nerve to the postganglionic neuron in the hypogastric nerve at the pelvic plexus. Ho … More rmonal control of sperm transport by the greater splanchnic nerve-adrenal medulla system was highly suspected.II.The mechanism of sperm trasport through the vas deferes.Direct electrical stimulation of any site of the cauda epididymis and vas deferens caused elevation of the intraluminal pressure only at the cauda epididymis, whereas stimulation of the testis, caput, and corpus epididymis caused no response. The dye instilled in the cauda epididymis was emitted into the urethra during the stimulation. Shortly after discontinuation of the stimulation, retrograde movement of residual dye in the vas deferens resulted in its ultimate reentry into the cauda epididymis. Distention of the wall of the vas generated elevation of the intraluminal pressure only at the site distended. The above results indicate the presence of rapid antegrade and retrograde movement of the sperm and crucial role of the cauda epididymis on the sperm transport.III.Anastomosis of the autonomic nerve.Function of the seminal tract including the vas deferens, bladder neck and prostate, was restored after transection and immediate microsurgical end-to-end suture of the hypogastric nerve.IV.A new method to generate canine seminal emission and its application to men : Direct electrical stimulation of the vas deferens.Stimulation of the vas deferens of patients with emission loss elicited seminal emission from the ejaculatory orifice and motile spermatozoa were obtained. Less