THE URETEROVESICAL INNERVATION A New Concept Based on a Histochemical Study

Abstract

THE classical concept of the innervation of the urinary tract pretends that the ureter is supplied by sympathetic nerves while the bladder receives essentially parasympathetic nerves.Morphological studies of the intrinsic innervation of the urinary tract have been limited for decades by classical microscopic techniques (such as intravital methylene blue or silver impregnation) which could not establish the difference between sympathetic (adrenergic) and parasympathetic (cholinergic) nerves.The application of new and highly specific histochemical methods for the demonstration of adrenergic (norepinephrine) and cholinergic (acetylcholinesterase) nerve elements has thrown new light on the organisation and dynamics of the autonomic innervation of the mammalian ureter and bladder.Material and Methods.-Specimens were taken from the ureters and bladders of 25 mongrel dogs and 5 rabbits. The tissues studied were excised under light intravenous nembutal anaesthesia and specimens were obtained from all levels of the ureter and bladder. The tissues were quickly frozen in liquid nitrogen and sectioned in a cryostat at -30°C. Transverse and sagittal serial sections of 10 to 20 p were selected every 100 to 200 p. At the level of the ureterovesical junction, serial sections were taken each 40 p. The sections were mounted on a frosted slide and subsequently stained after the different histochemical methods.Clzolinergic nerve elements were studied by the technique of Karnovsky and Roots (1964) as modified by El-Badawi and Schenk (1967) for the demonstration of acetylcholinesterase (AChE). AChE activity is characterised by a fine granular reddish-brown precipitate. The sections were studied under a Zeiss photomicroscope by ordinary light, phase contrast microscopy and Nomarski differential phase microscopy. Adrenergic nerves were demonstrated by the formaldehyde-induced fluorescence of catecholamines following the method of Falck et a/. (1962) as modified by Spriggs et a/. (1966). The sections were examined under a Zeiss fluorescent photomicroscope using a high-pressure mercury lamp, a BG 12 excitation filter and a 470 p barrier filter. Under these conditions the specific fluorescence of norepinephrine (NE) is identified by a yellowish-green fluorescence localised in varicosities along the sympathetic nerve fibres and in granular formations in the cytoplasm of adrenergic neurons (for details see Corrodi et al., 1967).The distribution of monoamine oxidase (MAO) activity was studied histochemically by the method of Glenner et a/. (1957). The sites of M A 0 activity are identified by deposits of a bluishpurple formazan pigment developed when tryptamine is oxidised by M A 0 following the reduction of nitroblue tetrazolium. RESULTSThis paper is limited to the description of the essential features of the ureteral and vesical

Immunohistochemical characteristics and distribution of neurons in the intramural ganglia supplying the urinary bladder in the male pig

“…It may be attributed most probably to interspecies differences or to different stage of the development of this part of the peripheral nerve system, that is known to be able to make so-called "transmitter switch" in the presence of particular trophic molecules vide the plasticity of the sweat gland innervation (Landis and Fredieu 1986). The finding of such big proportion of noradrenergic neurons in the bladder wall is probably due to the fact that similarly to human all the ganglia presently examined came from the bladder trigone and neck where noradrenergic nerves have been shown to be concentrated (Schulman et al 1972), especially in males . In this region noradrenergic nerves have been shown to cause smooth muscle contraction and thus closure of the bladder neck (Lincoln and Burnstock 1993) and in the male such nerves are activated at the time of seminal emission and prevent the reflux of semen into the bladder (so-called "retrograde ejaculation") (Krane and Olsson 1973).…”

The effect of smoking on spontaneous passage of distal ureteral stones

“…In their study they administered nicotine by intravenous, inhaled or topical route and shown that both intravenous and inhaled nicotine, although effective at different dosages, do alter the peristalsis of the ureter [5]. Nicotine most probably exhibits this effect on the ureter over the cholinergic receptors proven to be present in the ureter also [13]. Further studies have shown that in each breath of a cigarette smoked there is 120 μg nicotine and about 50% of this is absorbed to the circulation in humans.…”

Detrusor inhibition in suprasacral spinal cord injuries: is it due to sympathetic overactivity?

“…In the cat De Groat and Saum (1972) have shown that stimulating the sympathetic system inhibits the parasympathetic centre. Anatomical interconnections have been disclosed in animal between sympathetic and parasympathetic systems in the pathways from the lumbo-sacral centres to the bladder and particularly in the ganglionic perivesical plexus (Schulman et al, 1972). The micturition parasympathetic centre could be under continuous inhibitory control from sympathetic origin as would be the case in patients with spinal cord lesions above the thoracolumbar sympathetic centre (McGurie et al, 1976).…”