Age-related changes in the innervation of the prostate gland

Abstract

The adult prostate gland grows and develops under hormonal control while its physiological functions are controlled by the autonomic nervous system. The prostate gland receives sympathetic input via the hypogastric nerve and parasympathetic input via the pelvic nerve. In addition, the hypogastric and pelvic nerves also provide sensory inputs to the gland. This review provides a summary of the innervation of the adult prostate gland and describes the changes which occur with age and disease. Growth and development of the prostate gland is age dependent as is the occurrence of both benign prostate disease and prostate cancer. In parallel, the activity and influence of both the sympathetic and parasympathetic nervous system changes with age. The influence of the sympathetic nervous system on benign prostatic hyperplasia is well documented and this review considers the possibility of a link between changes in autonomic innervation and prostate cancer progression.

β-Adrenergic Receptor Signaling in Prostate Cancer

“…The prostate is highly innervated ( 33 ), and the nerves are required for formation of the prostate during embryogenesis, maturation during puberty, and maintenance of the adult phenotype ( 34 ). Thus, like androgen stimulation, sympathetic stimuli contribute to prostatic differentiation in vivo ( 35 ).…”

“…In normal prostate physiology, the sympathetic nervous system regulates prostate differentiation and secretory activity of luminal cells, predominantly through ADRB2 ( 34 , 35 , 40 , 41 ). We know from in vitro and in vivo prostate cancer models that chronic elevation of ADRB activity by exposing mice to repeated stress or by adding ADRB agonists promotes neuroendocrine differentiation ( 70 , 84 – 86 ), metastasis ( 58 , 103 ), angiogenesis ( 78 , 81 , 112 , 115 ), and apoptosis-resistance ( 116 , 120 ); together indicating that adrenergic signaling promotes prostate cancer progression (Figure 2 ).…”

Mechanism of Action of Botulinum Toxin A in Treatment of Functional Urological Disorders

“…The prostate growth's anatomical obstruction may be the main reason for lower urinary tract symptoms, but inflammation, infection, and metabolic disorders can also be possible etiologies [76]. The prostate is innervated with the parasympathetic and sympathetic nerves [77]. The cholinergic nerves and muscarinic receptors are present in the fibromuscular stroma of the prostate, which can explain the previous beneficial effects of BoNT-A intraprostatic injection treatments [78][79][80][81].…”

Prostate‐induced orgasms: A concise review illustrated with a highly relevant case study

“…Dense neuropeptide Y innervation is present throughout the prostatic stroma but most studies have not found the neuropeptide to be involved in the contraction of the prostate (White et al, ).…”

“…If the pelvic muscles do not contract the semen emission is one of dribbling, powered by the peristaltic contractions of the urethra alone with little ecstatic pleasure (Newman et al, ). Although orgasm normally takes place concomitantly with ejaculation, the two processes are actually independent (Levin, ).While the prostate is involved in forming part of the ejaculate (as detailed above) it is also involved in ejaculation per se as its fibromuscular covering containing smooth muscle contracts clonically under its adrenergic innervation propelling the semen from the prostatic urethra into the penile urethra (White et al, ).…”