Levator ani muscle innervation: Anatomical study in human fetus

Timoh, Krystel Nyangoh; Bessède, Thomas; Lebâcle, C.; Zaitouna, Mazen; Martinovic, Jéléna; Diallo, Djibril; Crézé, Maud; Chevallier, Jean‐Marc; Daraı̈, Émile; Galand, Benoît; Moszkowicz, David

doi:10.1002/nau.23145

Cited by 23 publications

(17 citation statements)

References 31 publications

(85 reference statements)

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“…Due to the lack of data dealing with immunohistochemical characterization of nerve structures in female reproductive organs during prenatal development in other mammalian species, it is impossible directly and comprehensively to compare the present results with earlier findings. Comparisons considering such different organs as the human heart (Gordon et al 1993;Siddiqui et al 2015), gut (Faussone-Pellegrini et al 2007), levator ani (Nyangoh et al 2016) or urinary bladder might not be too informative.…”

Section: Discussionmentioning

confidence: 99%

“…However, the present results indicate that there are certain common features concerning the development of the innervation of mammalian internal organs, including the porcine female reproductive tract. The nerves penetrate the organs from the outside (Gordon et al 1993;Keast et al 2015;Siddiqui et al 2015) and their immunohistochemical characteristics are changing dynamically; it seems that adrenergic and cholinergic fibres reach their targets clearly before the sensory nerve terminals (Gordon et al 1993;Keast et al 2015;Nyangoh et al 2016).…”

Section: Discussionmentioning

confidence: 99%

“…The research also concerns the innervation of the levator ani (Nyangoh et al. ), urinary bladder (Keast et al. ) and gut in human (Faussone‐Pellegrini et al.…”

Section: Introductionmentioning

confidence: 99%

“…; Nyangoh et al. ) but there are no data dealing with the innervation of female internal genital organs in the pig during prenatal development. This lack of information led to the observation of the innervation of the internal genital organs in the pig foetuses as an important animal model in biomedical research, due to the high compatibility of the tissue with human tissue.…”

Section: Introductionmentioning

confidence: 99%

“…Some research has been carried out on the heart of the human foetuses (Gordon et al 1993;Siddiqui et al 2015). The research also concerns the innervation of the levator ani (Nyangoh et al 2016), urinary bladder and gut in human (Faussone-Pellegrini et al 2007) and urinary tract in the dog foetuses (Arrighi et al 2008;Nyangoh et al 2016) but there are no data dealing with the innervation of female internal genital organs in the pig during prenatal development. This lack of information led to the observation of the innervation of the internal genital organs in the pig foetuses as an important animal model in biomedical research, due to the high compatibility of the tissue with human tissue.…”

Section: Introductionmentioning

confidence: 99%

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Innervation of internal female genital organs in the pig during prenatal development

et al. 2019

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This study investigated the innervation of internal genital organs in 5‐, 7‐ and 10‐week‐old female pig foetuses using single and double‐labelling immunofluorescence methods. The structure and topography of the organs was examined using a scanning electron microscope (SEM). The investigations revealed differences in the innervation between the three developmental periods. Immunostaining for protein gene product 9.5 (PGP; general neural marker) disclosed solitary nerve fibres in the external part of the gonadal ridge and just outside of the mesenchyme surrounding mesonephric ducts in 5‐week‐old foetuses. Double‐labelling immunohistochemistry revealed that nerve fibres associated with the ridge expressed dopamine β‐hydroxylase (DβH; adrenergic marker) or vesicular acetylcholine transporter (VAChT; cholinergic marker). In 7‐week‐old foetuses, the PGP‐positive nerve terminals were absent from the gonad but some of them ran outside and along, and sometimes penetrated into the mesenchyme surrounding the tubal and uterine segments of the paramesonephric ducts and uterovaginal canal. Few axons penetrated into the mesenchyme. DβH‐positive fibres were found in single nerve strands or bundles distributed at the edge of the mesenchyme. VAChT‐positive nerve terminals formed delicate bundles located at the edge of the mesenchyme, and the single nerves penetrated into the mesenchyme. DβH was also expressed by neurons which formed cell clusters comprising also DβH‐ or VAChT‐positive nerve fibres. In 10‐week‐old foetuses, PGP‐positive nerve fibres were still absent from the ovary but some were distributed in the mesenchyme associated with the uterovaginal canal and uterine and a tubal segment of the paramesonephric ducts, respectively. DβH‐ or VAChT‐positive nerve fibres were distributed at the periphery of the mesenchyme associated with the uterovaginal canal. Some DβH‐ and many VAChT‐positive nerve fibres were evenly distributed throughout the mesenchyme. The clusters of nerve cells comprised DβH‐positive perikarya and DβH‐ or VAChT‐positive nerve fibres. The investigations revealed no DβH/VAChT‐positive nerve fibres or neurons as well as no nerve structures stained for calcitonin gene‐related peptide and/or substance P (sensory markers) associated with the genital organs in the studied prenatal periods.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The research also concerns the innervation of the levator ani (Nyangoh et al. ), urinary bladder (Keast et al. ) and gut in human (Faussone‐Pellegrini et al.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Innervation of internal female genital organs in the pig during prenatal development

et al. 2019

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Smooth muscle of the male pelvic floor: An anatomic study

et al. 2019

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Introduction: Knowledge of the anatomy of the male pelvic floor is important to avoid damaging the pelvic floor muscles during surgery. We set out to explore the structure and innervation of the smooth muscle of the whole pelvic floor using male fetuses. Material and Methods: We removed en-bloc the entire pelvis of three male fetuses. The specimens were serially sectioned before being stained with Masson's trichrome and hematoxylin and eosin, and immunostained for smooth muscles, and somatic, adrenergic, sensory and nitrergic nerve fibers. Slides were digitized for 3D reconstruction. Accepted Article Results: We individualized a middle compartment that contains smooth muscle (SM) cells. This compartment is in close relation with the levator ani muscle (LAM), rectum, and urethra. We describe a posterior part of the middle compartment posterior to the rectal wall and an anterior part anterior to the rectal wall. The anterior part is split into 1) a centro-levator area of SM cells localized between the right and left LAM, 2) an endo-levator area that upholsters the internal aspect of the LAM, and 3) an infra-levator area below the LAM. All these areas are innervated by autonomic nerves coming from the inferior hypogastric plexus. The core and the infra-levator area receive the cavernous nerve and nerves supplying the urethra. Conclusion: We thus demonstrate that these muscular structures are smooth and under autonomic influence. These findings are relevant for the pelvic surgeon, and especially the urologist, during radical prostatectomy, abdominoperineal resection and intersphincteric resection.

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The male external urethral sphincter is autonomically innervated

et al. 2020

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Introduction The aim of the present study was to describe autonomic urethral sphincter (US) innervation using specific muscular and neuronal antibody markers and 3D reconstruction. Material and methods We performed en‐bloc removal of the entire pelvis of three male human fetuses between 18 and 40 weeks. Serial whole mount sections (5 μm intervals) were stained and investigated. The sections were stained with Masson's trichrome and Eosin Hematoxylin, and immunostained with: anti‐SMA antibody for smooth muscle; anti‐S100 antibody for all nerves; and anti‐PMP22 antibody, anti‐TH antibody, anti‐CGRP antibody, anti‐NOS antibody for somatic, adrenergic, sensory and nitrergic nerve fibers, respectively. The slides were digitized for 3D reconstruction to improve topographical understanding. An animated reconstruction of the autonomic innervation of the US was generated. Results The external and internal US are innervated by autonomic nerves of the inferior hypogastric plexus (IHP). These nerves are sympathetic (positive anti‐TH antibody), sensory (positive anti‐CGRP antibody), and nitrergic (positive anti‐NOS antibody). Some autonomic fibers run within the neurovascular bundles, posterolaterally. Others run from the IHP to the posteromedial aspect of the prostate apex, above an through the rectourethral muscle. The external US is also innervated by somatic nerves (positive anti‐PMP22 antibody) arising from the pudendal nerve, joining the midline but remaining below the rectourethral. Conclusions This study provides anatomical evidence of an autonomic component in the innervation of the external US that travels in the neurovascular bundle. During radical prostatectomy, the rectourethral muscle and the neurovascular bundles are to be preserved, particularly during apical dissection.

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Levator ani muscle innervation: Anatomical study in human fetus

Abstract: Our study provides a new representation of levator ani muscle innervation with three nerve pathways, and the levator ani muscle itself as an anatomical landmark.

Cited by 23 publications

References 31 publications

Innervation of internal female genital organs in the pig during prenatal development

Innervation of internal female genital organs in the pig during prenatal development

Smooth muscle of the male pelvic floor: An anatomic study

The male external urethral sphincter is autonomically innervated

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