Intrarenal and Extrarenal Autonomic Nervous System Redefined

Abstract

The autonomic nerves supplying the kidney maintain their distribution almost exclusively along the anterior surface of arteries as they pass from the aorta to the segmental arteries. Once inside the renal parenchyma, the nerves are circumferentially distributed around the renal arteries and are in close proximity to the renal collecting system.

Redefining the Autonomic Nerve Distribution of the Bladder Using 3-Dimensional Image Reconstruction

“…Our team has previously employed 3D reconstruction technology to characterize and localize the autonomic nerve distribution of both intra-and extra-renal anatomy 9 . Using histopathological evaluation, we were able to precisely track the course of microscopic autonomic nerves.…”

“…Modern advances in computer-aided image reconstruction technology allow microscopic nerve tissue in human organs to be systematically mapped in a three-dimensional (3D) format 9 .…”

The gross anatomy of the renal sympathetic nerves revisited

“…The latter has been explained as a consequence of the high variability of the renal nerves and ganglia (Tzafriri et al, ), variations in the renal arteries (Rimoldi et al, ; Okada et al, ), or aberrant reinnervation by sympathetic fibers post‐ablation (Booth et al, ). Several recent studies that support catheter‐based renal denervation techniques have used immunohistochemical methods to describe the location and density of nervous fibers around the renal artery (Atherton et al, ; Tellez et al, ; Sakakura et al, ) and its segmental branches (Lusch et al, ).However, none of these studies considered this information in the context of the classical descriptions of the sympathetic renal innervation (Legueu and Flandrin, ; Petit‐Dutaillis and Flandrin, ; Hovelacque, ; Testut, ; Delmas et al, ; Mitchell, ; Mitchell, ), nor did they include detailed anatomical descriptions of the renal plexus and vessels, including their anatomical relationships and variations.…”

Laparoscopic Kidney Denervation for Refractory Loin Pain: Can We Predict Outcomes?

“…Also noteworthy, Lusch et al have demonstrated that renal innervation is spread through the renal hilum. 6 Accordingly meticulous hilar skeletonizing is essential, demanding experienced surgeons to perform the procedure. It should be remembered that renal denervation is the last line of treatment for refractory loin pain of renal origin and before surgical indication other manners of symptoms control must be exhaustively tried.…”