著者

木村 行雄 宮田 宏洋 安達 国昭

出版者

社団法人 日本泌尿器科学会

雑誌

日本泌尿器科學會雑誌 (ISSN:00215287)

巻号頁・発行日

vol.62, no.11, pp.877-886, 1971-11-20 (Released:2010-07-23)

参考文献数

29

被引用文献数

1 1

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The nervous pathways controlling the two phenomena, seminal emission and closure of the internal urethral orifice were studied experimentally, using male mongrel dogs.Methods: The nerves examined in this study were the nerve fibers entering the lower mesenteric plexus, the splanchnic nerves and the lumbar nerves. The peripheral cut end of these nerves was electrically stimulated continuously with pulses of 0.5-5V in amplitude, 0.5-2msec in duration and 1-40cps in frequency.For seminal emission and ejaculation, posterior urethrogram was recorded by the method described in a previous report. For measurement of contraction of the internal urethral orifice, a latex balloon fitted at the tip of a No. 6 polyethylene tube was inserted into the internal urethral orifice and alteration of the pressure in the balloon was recorded.The results obtained were as follows:1) Selective Stimulation on the Nerve Fivers enterining the lower Mesenteric Plexus.In this study the nerve fibers descending on the anterior wall of the aorta into the plexus were tentatively nominated as the central branch of the lower mesenteric plexus and the fibers entering from the lateral portion into the plexus as the lateral branch of the plexus.When the central branch was stimulated, seminal emission occurred and contraction of the internal urethral orifice was not noted. On the other hand, when the lateral branch was stimulated, emission did not occur but the marked contraction in the internal urethral orifice was observed.2) Stimulation of the Splanchnic Nerves.Seminal emission was caused by stimulation of the greater splanchnic and the third lesser splanchnic nerves. The degree of emission was more remarkable on stimulation of the latter nerve. In regard to contraction of the internal urethral orifice, it was observed that when the 4th-6th lesser splanchnic nerves were stimulated the internal orifice contracted. In particular, contraction was most marked when the 5th lesser splanchnic nerve was stimulated. Accordingly, it was thought that seminal emission and contraction of the internal urethral orifice during ejaculation were controlled by the different nerve pathways upper the lower mesenteric plexus.3) Stimulation of the Lumbar Nerves.In this study, seminal emission was examined alone.Slight emission was observed when the anterior roots of the 1st and 2nd lumbar nerves were stimulated. A remarkable emission was found to occur when the anterior root of the 3rd lumbar nerve was stimulated. Emission was not observed on stimulation of the other lumbar nerves and the posterior roots of the lumbar nerves.

著者

木村 行雄 宮田 宏洋 安達 国昭

出版者

社団法人 日本泌尿器科学会

雑誌

日本泌尿器科學會雑誌 (ISSN:00215287)

巻号頁・発行日

vol.63, no.5, pp.343-345, 1972 (Released:2010-07-23)

参考文献数

1

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The peripheral nervous controls of seminal emission and closure of the internal urethral orifice during ejaculation were examined experimentally and the hypothesis reported in the previous paper was confirmed.Methods: The hypogastric nerve and the fibers entering the hypogastric plexus which were grouped and referred to as the central branch of the hypogastric plexus and the lateral branch were exposed and sectioned. After 1-4 weeks postoperatively, the penis of the operated dogs was manually stimulated without anesthesia and changes in ejaculation were observed.The results obtained are as follows:i) Section of the bilateral hypogastric nerves. Ejaculation did not occur after 1-4 weeks postoperatively. Disappearance of ejaculation was found to be due to retrograde ejaculation, i. e. regurgitation of the semen into the bladder, but not due to the loss of seminal emission.ii) Selective section of the nerve fibers entering the hypogastric plexus.In the dogs whose median branch was cut, ejaculation occurred just like before section of the branch. No retrograde ejaculation occurred in these dogs. In 5 dogs whose lateral branch was sectioned, ejaculation disappeared in all dogs. In 3 of the 5 dogs retrograde ejaculation occurred and in a dog many spermatozoa were found in the urethra. In only one dog emission disappeared completely.From these results it is concluded that the nerve fibers controlling seminal emission and closure of the internal urethral orifice during ejaculation may take different passways above the hypogastric plexus and these results also confirmed those reported in the previous report.

著者

木村 行雄 安達 国昭 木崎 徳 伊勢 和久

出版者

社団法人 日本泌尿器科学会

雑誌

日本泌尿器科學會雑誌 (ISSN:00215287)

巻号頁・発行日

vol.65, no.4, pp.218-228, 1974 (Released:2010-07-23)

参考文献数

22

被引用文献数

1

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For the past 4 years and half 39 cases with ejaculatory disturbance were experienced in our clinic.1) Age and Incidence. The incidence of ejaculatory disturbance was 0.5% of the whole outpatients of our clinic. The age of the patients ranged between 17 to 40 years with the highest incidence in the thirties.2) Classification of ejaculatory disturbance. In this report ejaculatory disturbance was classified into 4 groups: Group A; the patients who complained of abscence of both ejaculation and orgasm; Group B, the patients who complained of absence of ejaculation but maintained orgasm; Group C, the patients who maintained both ejaculation and orgasm; Group D, the patients who maintained ejaculation but complained of loss of orgasm. The incidence of these 4 groups were as follows: Group A, 15 cases (38%); Group B, 8 cases (21%); Group C, 13 cases (33%); and Group D, 3 cases (8%).3) Past history. In Group A, 6 cases had past history of mental diseases; 1 case, polyomyelitis; and 1 case, stomach ulcer. In these cases ejaculatory disturbance occurred during the medication for the diseases. Therefore, these diseases or the medication for them were suspected to be the causative factors of ejaculatory disturbance. No specific history which was suspected of relation to ejaculatory disturbance was found in Group B, C, and D.4) Physical examinations. No remarkable findings were obtained in the physical examinations throughout the groups.5) X-ray examinations. Plain films of lumbo-pelvic region. Spina bifida occulta was seen in 4 cases of 39 cases with ejaculatory disturbance; abnormal enlargement of the intravertebral space, in 1 case; and deformity in the lumbar vertebra, in 1 case. The relation between these anomalies and ejaculatory disturbance could not be clarified.Cystography. No remarkable finding was seen in Group A, C, and D. In Group B patency of the internal urethral orifice was seen in 7 cases. In 6 of these 7 cases the internal urethral orifice opened slightly by abdominal straining and in 1 case the orifice was seen patent without the straining. In one case irregularity of the internal urethral orifice was seen. Retrograde ejaculation occurred by masturbation in these cases. Therefore, cystography was found to be effective in diagnosis of retrograde ejaculation.Urethro-vesicography. In 1 case of Group B patency of the internal urethral orifice was seen and in 1 case irregularity of the posterior urethra was seen. In Groups A, C, and D no remarkable finding was seen.6) Reflexes and sensory and motor disturbances. Some cases of ejaculatory disturbance showed abnormality in reflexes, sensory and/or motor disturbances. However, the relation between these disturbances and ejaculatory disturbance was not clarified.7) Cystometrogram. In 13 of 15 cases of Group A some abnormalities were suspected in the higher center of the urinary bladder. The cystometrogram in these cases was hypotonic without micturition contraction. Both the effect of nitrazepam administration and respiratory effect on the cystometrogram were clearly seen. Two of 15 cases showed disturbance of the peripheral nerves in addition to them. In Group B there was no case which showed abnormal cystometrogram except for a case in which the lesion was suspected in the lower region of the spinal cord. In Group C and D there was no case which showed abnormal cystometrogram.8) Treatment. In Group A vitamin B1, vitamin E, androgen, tranquilizers and imipramine hydrochloride were administered, but no remarkable effect was obtained by them. However, trihydroxpropiophenone, a COMT inhibitor, showed marked effect on 2 cases of Group A. In Group B the internal urethral orifice was narrowed by plastic operation. After the operation ejaculation became normal with normal orgasm. In the cases of Group C and D, the same drugs as in the Group A were used. But no remarkable effect was obtained by these drugs except for a case of Group C