A three dimensional nerve map of human bladder trigone.
Abstract
Central efferent and afferent neural pathways to and from the human urinary bladder
are well-characterized, but the location and arborization of these nerves as they
traverse the serosa, muscularis, and urothelial layers are not clearly defined. The
purpose of this study was to create a three dimensional map of the innervation of
the human bladder trigone from the extrinsic perivesical adventitial nerve trunks
to the urothelium.A male and a female human bladder were harvested from fresh frozen
cadavers and fixed in formalin. The bladder neck and trigone region were serially
sectioned (5 μm) and every 20th slide was stained (S100), scanned and aligned to create
3D maps.Nerve penetration into the detrusor muscle occurs with the highest frequency
at the bladder neck and interureteric ridge. Nerves traveling parallel to the bladder
lumen do so in the adventitia, beyond the outer border of detrusor. In females, the
depth of these nerve bands is uniform at 0.7-1.7 cm below the luminal surface, the
outer limits of which include the anterior vaginal wall. In the male, depth is more
variable owing to detrusor hypertrophy with the minimum depth of nerves approximately
0.5 cm near the interureteric ridge and over 1 cm near the bladder neck.Myelinated
neural pathways traversing in the human bladder in the region of the trigone have
a discreet regional density. This 3D map of trigonal innervation may provide guidance
to more precisely direct therapies for urinary incontinence or pelvic pain. Neurourol.
Urodynam. 36:1015-1019, 2017. © 2016 Wiley Periodicals, Inc.
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https://hdl.handle.net/10161/17173Published Version (Please cite this version)
10.1002/nau.23049Publication Info
Purves, J Todd; Spruill, Laura; Rovner, Eric; Borisko, Elyse; McCants, Alden; Mugo,
Elizabeth; ... Hughes, Francis M (2017). A three dimensional nerve map of human bladder trigone. Neurourology and urodynamics, 36(4). pp. 1015-1019. 10.1002/nau.23049. Retrieved from https://hdl.handle.net/10161/17173.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Monty Hughes Jr.
Assistant Professor in Urology
Dr. Hughes received his Ph.D. from the Medical University of South Carolina and was
a post doc at both the University of North Carolina at Chapel Hill and NIH. He then
joined the faculty of the University of North Carolina at Charlotte where he rose
to the rank of Associate Professor (with tenure). Following a brief stint as the director
of the biology division of a start-up pharmaceutical company, he joined forces with
Dr. Purves at the Medical University of South Carolina to begin this l
J Todd Purves
Professor of Urology
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