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Human pelvic extramural ganglion cells: a semiquantitative and immunohistochemical study

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Abstract

In pelvic surgery, much attention is paid to nerve bundles but not to ganglion cells. Using serial section histology of 14 postmortem-treated hemipelvis (eight males, six females; mean, 79 years old), we examined the population number, distribution, and tyrosine hydroxylase-immunoreactivity (TH-IR; suggesting sympathetic neurons) of extramural pelvic ganglion cells. All pelvic ganglion cells were uniformly sized (25–30 μm) contrasting with small intramural rectal neurons. Abundant ganglion cells (30,000–140,000 unilaterally) existed not only along the pelvic viscera except for the rectum, but also along the hypogastric nerve, pelvic splanchnic nerve, pelvic plexus, and associated branches excluding those within the mesorectum. The intrapelvic ganglion cells outside the sympathetic trunk did not form macroscopically identifiable ganglia, but made small clusters (0.1–2.0 mm of maximum diameter) or were diffusely scattered within nerve bundles. More than half of these cells appeared TH-IR positive, although the positive/negative proportion differed between nerves and specimens. Greater numbers of ganglion cells were found in dorsosuperior sites (e.g., around the seminal vesicle) rather than in ventroinferior sites (e.g., along the urethra) in males, and vice versa in females. However, in total cell numbers, interindividual variations were evident rather than intergender difference. Due to significant interindividual variations in cell number, differences are likely to exist between patients in “resistance” to surgical stresses. We hypothesized that pelvic ganglion cells are liable to be damaged due to drying along the surgical margin, hypoxia in venous bleeding, pressure from surgical retractors, extension stress with taping and excess traction and/or direct injury with electrical scalpels.

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Acknowledgments

We thank Mr. Seiji Ohtani and Ms. Mami Yamaguchi in the biomedical laboratory center of Sapporo Medical University for their assistance in immunohistochemistry. We are also grateful to Professor Toshihiko Yajima (Department of Oral Anatomy, Health Science University of Hokkaido School of Dentistry) for kind permission of the use of his materials.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, National Defense Medical College, Saitama, 359-8513, Japan

    Kanoko Imai & Kenichi Furuya

  2. Department of Surgery, Kochi University School of Medicine, Kochi, Japan

    Michihiro Kawada

  3. Department of Surgery, Tokyo Medical and Dental University School of Medicine, Tokyo, Japan

    Yusuke Kinugasa

  4. Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan

    Kiichi Omote & Akiyoshi Namiki

  5. Department of Anatomy, Sapporo Medical University School of Medicine, Sapporo, Japan

    Eiichi Uchiyama & Gen Murakami

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  1. Kanoko Imai
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  2. Kenichi Furuya
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  3. Michihiro Kawada
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  4. Yusuke Kinugasa
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  8. Gen Murakami
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Correspondence to Gen Murakami.

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Imai, K., Furuya, K., Kawada, M. et al. Human pelvic extramural ganglion cells: a semiquantitative and immunohistochemical study. Surg Radiol Anat 28, 596–605 (2006). https://doi.org/10.1007/s00276-006-0156-2

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  • DOI: https://doi.org/10.1007/s00276-006-0156-2

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