On the abdominal and pelvic autonomic nerve system with reference to surgical cancer operation

Abstract

The autonomic nervous system controlling the abdominal and pelvic organs has elaborate mechanisms to preserve its function against various surgical operations. The main sympathetic signals from the lumbar spinal cord to the pelvic organs proceed the common pathway in mammalians, which consists of the lumbar splanchnic nerve, inferior mesenteric ganglion (superior hypogastric plexus: in man), hypogastric nerve, pelvic plexus and its branches. On the way of this common pathway, some signals cross to the other side of the body at the level of the inferior mesenteric ganglion (superior hypogastric plexus: in man). The preganglionic axons passing through the hypogastric nerve very likely provide a bilateral innervation to postganglionic neurons in the pelvic plexuses, which also exhibit crossing to the bilateral pelvic organs. Another sympathetic nerves originating from the thoracic spinal cord possibly influence it by the hormonal system consisting of the major splanchnic nerve and the adrenal medulla. When the common sympathetic pathway is interrupted, various compensatory mechanisms are generated: enhancement of the remaining sympathetic pathways or reorganization of synaptic connection in the pelvic plexus. The parasympathetic nerve system via pelvic (splanchnic) nerve from the sacral spinal cord provide to the pelvic organs. Surgical reconstruction of the transected hypogastric nerve and pelvic nerve are possible and cross-innervation mechanism via the hypogastric nerve can also be preserved in the dog.