Neurobiología y neuroplasticidad del prepucio
DOI:
https://doi.org/10.48193/kkhp7044Palabras clave:
Circuncisión, inervación del prepucio, fisiología del prepucio, neuroplasticidadResumen
El prepucio masculino es la piel que cubre y protege al glande. Esta estructura ha sido subestimada, estigmatizada e incluso extirpada por razones no médicas. El objetivo principal de esta revisión es resumir la literatura actual sobre la neurobiología del prepucio, y de manera secundaria discutir el efecto potencial de la circuncisión y la axotomía asociada sobre la neuroplasticidad y la fisiología urogenital masculina. La ontogenia e inervación del prepucio incluyen desarrollo prenatal y posnatal, con fimosis fisiológica al nacimiento. La separación del glande es dependiente de andrógenos y ocurre durante la infancia y la adolescencia. A diferencia del glande, el prepucio está inervado por una densa red de receptores sensoriales corpusculares, terminaciones nerviosas especializadas esenciales para la percepción de diversas sensaciones táctiles, como el tacto ligero, la presión, la vibración y el estiramiento. Por lo tanto, el prepucio es un tejido sensorial especializado, con posibles funciones en la percepción sexual y la modulación de reflejos genitales. Su ablación puede inducir una reorganización neural periférica y central, pero poco se sabe sobre la neuroplasticidad asociada a la axotomía de nervios genitales. Investigaciones preclínicas permitirán dilucidar los mecanismos neuroplásticos y sus implicaciones a largo plazo, así como interpretar los hallazgos clínicos.
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