Effect of serotoninergic and cholinergic nervous systems and corresponding neurotransmitters on heart function and motor activity of pelvic smooth muscle organs.

Serotonin potentiated vagal negative chronotropic effect in rabbits and increased the synergistic action of autonomic nervous structures on cardiac function in frogs. Acetylcholine in low doses produced a positive chronotropic effect in frogs, which was related to activation of intracardiac adrenergic neurons. Simultaneous activation of the serotoninergic and cholinergic system suppressed heart function, but increased motor activity of pelvic smooth muscle organs.

Histochemical and immunohistochemical studies on intraepithelial nerve fibers in the ejaculatory duct of the monkey (Macaca fuscatus).

With special attention to intraepithelial nerve supply, the distribution of peripheral nerve fibers in the ejaculatory duct of the monkey (Macaca fuscatus) was examined by histochemical and immunohistochemical methods and conventional transmission electron microscopic (TEM) method. The conventional TEM study has suggested that there are two types of intraepithelial nerve fibers, i.e. cholinergic and peptidergic. Acetylcholinesterase (AChE)-positive nerve fibers which were seen by means of light microscopy (LM) as surrounding the epithelium were revealed to be present intraepithelially by means of TEM examination. Neuropeptide Y (NPY)-like immunoreactive nerve fibers were richly distributed in the ejaculatory duct with a dense plexus spreading just beneath the epithelium. The immunoreactive nerves appeared, in part, to enter the epithelium. Substance P (SP)- and calcitonin gene-related peptide (CGRP)-like immunoreactive nerve fibers were found to be present to a moderate extent in the ejaculatory duct; some of them entered the interior of the epithelium to extend their nerve terminals to its free surface. Neural elements clearly immunoreactive for tyrosine hydroxylase (TH) and vasoactive intestinal peptide (VIP) could not be found in the ejaculatory duct, except for the surroundings of the blood vessels. Possible functional roles of these intraepithelial nerves were discussed on the basis of their distribution pattern.

[Aortic surgery and sexual function]. / Chirurgia dell'aorta e funzione sessuale.

An account is offered of the haemodynamic and neurological questions posed by the relation between reconstructive aortoiliac surgery and sexual function. Attention is drawn to the anatomical and surgical features of the preaortic sympathetic structures. In the light of experience gained in pelvic haemodynamic evaluation with the Doppler penile pressure index, a method that has proved very useful in the study of pre- and postoperative impotence in the arteriopathic subject, stress is laid on three conclusions: a) the high frequency of impotence in aortoiliac arteriopathy (65% in a personal series); b) the beneficial effect on penile circulation of revascularisation of the hypogastric artery (increase in pressure index in 70% of cases); c) the relatively high incidence of postoperative sexual disturbances (30% in the personal series) due to lesion of the preaortic sympathetic structures, the risk being greater with techniques requiring wide exposure of the aorta. This danger is foreseeable in all sexually potent patients and should determine the indication for surgery, the method chosen (extra-peritoneal route, extra-anatomical by-pass), and the technique (in an aorto-femoral by-pass, the aorta should be prepared in accordance with carefully followed rules of surgical anatomy, and confined wherever possible to a short infrarenal segment).