title: Precise Characterization and 3-Dimensional Reconstruction of the Autonomic Nerve Distribution of the Human Ureter.
abstract: We sought to characterize and 3-dimensionally reconstruct the distribution of the autonomic innervation of the human ureter.
  
  
  
  Three male and 3 female pairs of ureters were evaluated at 2 mm serial transverse sections along the entire length of the ureter. The location of nerve tissue was immunohistochemically identified using the neuronal marker, S100 protein. ImageJ software was used to calculate nerve count and density in the adventitia and smooth muscle. Blender® graphics software was used to create a 3-dimensional reconstruction of autonomic nerve distribution.
  
  
  
  Within the adventitia nerve density was highest in the mid and distal ureter (females 2.87 and 2.71 nerves per mm2, and males 1.68 and 1.69 nerves per mm2) relative to the proximal ureter (females and males 1.94 and 1.22 nerves per mm2, respectively, p >0.0005). Females had significantly higher nerve density throughout the adventitia, especially in the distal ureter (2.87 vs 1.68 nerves per mm2, p <0.0005). In smooth muscle the nerve density progressively increased from the proximal to the distal ureter (p >0.0005). Smooth muscle nerve density was similar in the 2 genders (p = 0.928). However, in females nerve density was significantly higher in the first 2 cm of the distal ureter relative to the second 2 cm (3.6 vs 1.5 nerves per mm2, p <0.001) but not in males (3.0 vs 2.1 nerves per mm2, p = 0.126).
  
  
  
  Nerve density was highly concentrated at the distal ureter in the adventitia and smooth muscle of the male and female human ureters. The female ureter had greater nerve density in the adventitia, and in smooth muscle nerves were significantly concentrated at the ureteral orifice and the ureteral tunnel.
authors.affiliation: Department of Urology, University of California-Irvine, Orange, California.
authors.forename: Simone L
authors.initials: SL
authors.lastname: Vernez
authors.affiliation: Department of Urology, University of California-Irvine, Orange, California.
authors.forename: Zhamshid
authors.initials: Z
authors.lastname: Okhunov
authors.affiliation: Department of Anatomy and Neurobiology, University of California-Irvine, Orange, California.
authors.forename: Jamie
authors.initials: J
authors.lastname: Wikenheiser
authors.affiliation: Department of Urology, University of California-Irvine, Orange, California.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Khoyilar
authors.affiliation: Department of Urology, University of California-Irvine, Orange, California.
authors.forename: Rahul
authors.initials: R
authors.lastname: Dutta
authors.affiliation: Department of Urology, University of California-Irvine, Orange, California.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Osann
authors.affiliation: Department of Urology, University of California-Irvine, Orange, California.
authors.forename: Kamaljot
authors.initials: K
authors.lastname: Kaler
authors.affiliation: Department of Pathology, University of California-Irvine, Orange, California.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Lee
authors.affiliation: Department of Urology, University of California-Irvine, Orange, California.
authors.forename: Ralph V
authors.initials: RV
authors.lastname: Clayman
authors.affiliation: Department of Urology, University of California-Irvine, Orange, California. Electronic address: landmanj@uci.edu.
authors.forename: Jaime
authors.initials: J
authors.lastname: Landman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017776:Autonomic Pathways / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D002102:Cadaver; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D014513:Ureter / Q000000981:diagnostic imaging / Q000294:innervation*
keywords: adventitia; autonomic pathways; imaging; muscle; smooth; three-dimensional; ureter