Anat Cell Biol.  2014 Mar;47(1):55-65. 10.5115/acb.2014.47.1.55.

Topohistology of sympathetic and parasympathetic nerve fibers in branches of the pelvic plexus: an immunohistochemical study using donated elderly cadavers

• Hinata N
• Hieda K
• Sasaki H
• Murakami G
• Abe S
• Matsubara
• Miyake H
• Fujisawa M

• KMID: 2168857
• DOI: http://doi.org/10.5115/acb.2014.47.1.55

Abstract

Although the pelvic autonomic plexus may be considered a mixture of sympathetic and parasympathetic nerves, little information on its composite fibers is available. Using 10 donated elderly cadavers, we investigated in detail the topohistology of nerve fibers in the posterior part of the periprostatic region in males and the infero-anterior part of the paracolpium in females. Neuronal nitric oxide synthase (nNOS) and vasoactive intestinal polypeptide (VIP) were used as parasympathetic nerve markers, and tyrosine hydroxylase (TH) was used as a marker of sympathetic nerves. In the region examined, nNOS-positive nerves (containing nNOS-positive fibers) were consistently predominant numerically. All fibers positive for these markers appeared to be thin, unmyelinated fibers. Accordingly, the pelvic plexus branches were classified into 5 types: triple-positive mixed nerves (nNOS+, VIP+, TH+, thick myelinated fibers + or -); double-positive mixed nerves (nNOS+, VIP-, TH+, thick myelinated fibers + or -); nerves in arterial walls (nNOS-, VIP+, TH+, thick myelinated fibers-); non-parasympathetic nerves (nNOS-, VIP-, TH+, thick myelinated fibers + or -); (although rare) pure sensory nerve candidates (nNOS-, VIP-, TH-, thick myelinated fibers+). Triple-positive nerves were 5-6 times more numerous in the paracolpium than in the periprostatic region. Usually, the parasympathetic nerve fibers did not occupy a specific site in a nerve, and were intermingled with sympathetic fibers. This morphology might be the result of an "incidentally" adopted nerve fiber route, rather than a target-specific pathway.

Keyword

Pelvic autonomic nerve plexus; Neuronal nitric oxide synthase; Vasoactive intestinal polypeptide; Tyrosine hydroxylase; Human anatomy

MeSH Terms

Adrenergic Fibers
Aged*
Cadaver*
Female
Humans
Hypogastric Plexus*
Male
Myelin Sheath
Nerve Fibers*
Nitric Oxide Synthase Type I
Tyrosine 3-Monooxygenase
Vasoactive Intestinal Peptide
Nitric Oxide Synthase Type I
Tyrosine 3-Monooxygenase
Vasoactive Intestinal Peptide

Figure

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  Fig. 1 Topohistology of target regions for the present immunohistochemistry. Panels (A) and (B) (or C and D) are adjacent sagittal sections. Panels (A) and (C) exhibit elastica-Masson staining, while panels (B) and (D) display nerve mapping according to immunohistchemistry of S100. Pa nels (A) and (B) (a 91-year-old woman) include the bladder (BL), ure thra (U) and vagina (V), while panels (C) and (D) (an 88-year-old man) includes the urethra, prostate (P) and rectum (R). We examined topohistology of sympathetic and para sym pathetic nerve fibers in the poste rior periprostatic region as well as in the infero-anterior part of the para colpium in females (stars in panels B and D). Panel (B) (or D) contains 385 (or 498) nerves. BP, bulbus penis; CG, Cowper's gland. All panels were prepared at the same magnification. Scale bar in panel (A)=10 mm (A-D).

• 

  Fig. 2 Nerve distribution in the antero-inferior part of the paracolpium. S100 immunohistochemistry. Frontal section. A specimen from an 88-year-old-woman. Composite nerve fibers of the numbered nerves (nerve-1, -2, -3, -4, -5, -6, -7, -8, and -9) will be shown in Figs. 3, 4, 5. Scale bar=1 mm.

• 

  Fig. 3 Sympathetic and parasympathetic nerve fibers in the paravaginal nerves-I. Topographical relation among the nerves-1, -2, -3 was shown in Fig. 2. The parasympathetic nerve markers are neuronal nitric oxide synthase (nNOS) and vasoactive intes tinal polypeptide (VIP), while the sympathetic marker is tyrosine hydroxylase (TH). The left-hand side column displays immuno histochemistry of nNOS, the middle column shows that of VIP and the right-hand side column exhibits that of TH. (A-C) Nerve-1 is rich in nNOS- and VIP-positive nerve fibers: the area of the latter fibers (VIP) appears not to contain TH-positive fibers (encircled by dotted line in panels B and C). (D-F) Nerve-2 is negative for VIP. (G-I) Nerve-3 contains a few VIP-positive nerve fibers (arrows in panel H). These results are summarized in Table 1. All panels were prepared at the same magnification. Scale bar in panel (G)=0.1 mm (A-I).

• 

  Fig. 4 Sympathetic and parasympathetic nerve fibers in the paravaginal nerves-II. Topographical relation among the nerves-4, -5, -6 was shown in Fig. 2. The left-hand side column displays immunohistochemistry of neuro nal nitric oxide synthase (nNOS), the middle column shows that of vasoactive intestinal poly peptide (VIP) and the right-hand side column exhibits that of tyrosine hydroxylase (TH). (A-C) One of nerves-4 does not contain VIP-positive nerve fibers. (D-F) Nerve-5 appears to be negative for VIP. (G-I) Nerve-6 is negative for VIP. These results are sum marized in Table 1. All panels were pre pared at the same magnification. Scale bar in panel (G)=0.1 mm (A-I).

• 

  Fig. 5 Sympathetic and parasympathetic nerve fibers in the paravaginal nerves-III. Topographical relation among the nerves-7, -8, -9 was shown in Fig. 2. The left-hand side column displays immunohistochemistry of neuronal nitric oxide synthase (nNOS), the middle column shows that of vasoactive intestinal poly peptide (VIP) and the right-hand side column exhibits that of tyrosine hydroxylase (TH). (A-C) In nerve-7, the area of VIP-positive nerve fibers appears not to contain TH-positive fibers (encircled by dotted line in panels B and C). (D-F) In nerve-8, the area of nNOS-positive nerve fibers appears not to contain VIP-posi tive fibers (encircled by dotted line in panels D and E). (G-I) Nerve-9 contain a few VIP-positive fibers (arrows in panel H). These results are sum marized in Table 1. All panels were pre pared at the same magnification. Scale bar in panel (G)=0.1 mm (A-I).

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  Fig. 6 Sympathetic and parasympathetic nerve fibers in the aortic wall. Frontal section. A specimen from an 88-year-old-woman (the speci men same as in Figs. 2, 3, 4, 5). In the antero lateral part of the paracol pium. Panel (A) displays S100 immuno histochemistry: this region con tains thick branches of the inter nal pudendal artery (artery) and a part of the rhab dosphincter. Scale bar=1 mm (A). The striated muscle fibers show false positive reaction with neuronal nitric oxide synthase (nNOS) antibody. Note abundant S100-positive fibers in the arterial wall (arrowheads in panel A). Panels (B), (C), and (D) exhibit a nerve in a square with B, C, D in panel (A). Nerve-10 contains no vasoactive intestinal polypeptide (VIP)-positive fibers. Panels (E), (F), and (G) show nerve fibers in a square with E, F, G in panel (A). The arterial wall contains nNOS-positive fibers as well as tyrosine hydroxylase (TH)-positive fibers (arrows in panel F and G). These results are summarized in Table 1. Panels (B-G) were prepared at the same magnification. Scale bar in panel (E)=0.1 mm (B-G).

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  Fig. 7 Sympathetic and parasympathetic nerve fibers along the levator ani muscle. Frontal section. A specimen from an 88-year-old-woman (the specimen same as in Figs. 2, 3, 4, 5, 6). Along the levator ani muscle (LAM) in the lateral part of the paracolpium, panel (A) displays nerve distribution using S100 immunohistochemistry. Scale bar=0.5 mm (A). Panels (B), (C), and (D) exhibit nerve-11 in panel (A). This nerve contains a few tyrosine hydroxylase (TH)-positive fibers (arrows). Panels (E), (F), and (G) show nerve-12, a pure sensory nerve candidate. Panels (H), (I), and ( J) display TH-single positive nerve-13. In panel (H), brown dots (arrows) appear to be false positive. Panels (K) and (L) exhibit one of multiple nerve bundles of the pudendal nerve in the outside of panel (A). These results are summarized in Table 1. Panels (B-J) (or panels K and L) were prepared at the same magnification. Scale bar in panels (E) and (K)=0.1 mm (B-J), 0.1 mm (K, L). nNOS, neuronal nitric oxide synthase; VIP, vasoactive intestinal polypeptide.

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