MALE UROGENITAL FUNCTION AND CHRONIC SPINAL CORD INJURY

参与控制/协调的神经机制 泌尿生殖功能知之甚少，使功能恢复 创伤性脊髓损伤后的治疗是一项艰巨的任务。在人类中， 损伤主要发生在年轻男性，损害性功能， 使大多数患者因无法射精而不育。此外，委员会认为， 由于膀胱-括约肌协同失调，膀胱排尿功能障碍是常见的。 会阴运动神经元回路不协调，由脊髓引起 损伤引起的非运动节段性反射回路的变化涉及 男性生殖功能和排尿，可能有助于这些 并发症因为正常的射精和排尿都需要一个完整的 节段性反射弧和脑干整合，我们有，在最近几年， 开发并表征了体内脑干脊髓 电生理动物模型，以研究性行为的神经原因 严重胸中脊髓损伤后的功能障碍。我们以前的 该模型的研究表明， T8脊髓的3/5与（i）膀胱/性反射受损相关， (ii)腰骶神经回路介导会阴肌功能的变化 和（iii）远端之间的上行和下行连接的丧失 泌尿生殖道和髓质网状结构（ii/iii -根据测定 在终端电生理学实验中）。建议的总体目标 研究就是利用这个脊髓-眼球-脊髓模型来解决重要的问题 关于平滑肌和横纹肌的神经控制/协调 慢性脊髓损伤后雄性大鼠的性功能和膀胱功能 脊髓损伤我们的模式的一个独特优势在于我们能够专注于 盆腔多脏器信息整合。获得的知识 从这些基本的科学实验将更具体地确定 脊髓区域和特定的神经回路， 治疗干预旨在改善控制/协调 慢性脊髓损伤后的性功能、膀胱功能和肠功能。 并行的电生理学、行为学和神经解剖学研究是 提出了

The neural mechanisms involved in the control/coordination of urogenital functions is poorly understood, making restoration of function following traumatic spinal cord injury a difficult task. In humans, spinal cord injury occurs predominantly in young males, compromises sexual function, and leaves most patients infertile because of an inability to ejaculate. Moreover, bladder voiding dysfunction is common due to bladder-sphincter dyssynergia. Incoordination of perineal motoneuron circuits, resulting from spinal cord injury-induced changes in non-locomotor segmental reflex circuits involved in male reproductive function and micturition, likely contributes to these complications. Since normal ejaculation and micturition require both an intact segmental reflex arc and brainstem integration, we have, in recent years, developed and characterized an in vivo brainstem-spinal cord electrophysiological animal model to study the neurological causes of sexual dysfunction following severe midthoracic spinal cord injury. Our previous studies with this model have shown that chronic bilateral lesions of the dorsal 3/5 of T8 spinal cord is correlated with (i) impaired bladder/sexual reflexes, (ii) changes in lumbosacral neural circuits mediating perineal muscle function and (iii) loss of ascending and descending connections between the distal urogenital tract and the medullary reticular formation (ii/iii - as determined in terminal electrophysiological experiments). The overall aim of the proposed research is to use this spino-bulbo-spinal model to address important questions regarding the neural control/coordination of smooth and striated muscles subserving sexual and bladder functions in male rats following chronic spinal cord injury. A unique benefit of our model lies in our ability to focus on the integration of information from multiple pelvic viscera. The knowledge gained from these basic scientific experiments will more specifically ascertain the spinal cord regions and the specific neural circuitry which should be targeted for therapeutic interventions designed to improve the control/coordination of sexual, bladder and bowel functions following chronic spinal cord injury. Parallel electrophysiological, behavioral and neuroanatomical studies are proposed.