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• W2099588355 abstract "No AccessJournal of UrologyAdult Urology1 Apr 2015Anatomical Study of Pelvic Nerves in Relation to Seminal Vesicles, Prostate and Urethral Sphincter: Immunohistochemical Staining, Computerized Planimetry and 3-Dimensional Reconstruction Roman Ganzer, Jens-Uwe Stolzenburg, Jochen Neuhaus, Florian Weber, Rudolf Fuchshofer, Maximilian Burger, and Johannes Bründl Roman GanzerRoman Ganzer Department of Urology, University of Leipzig, Leipzig, Germany More articles by this author , Jens-Uwe StolzenburgJens-Uwe Stolzenburg Department of Urology, University of Leipzig, Leipzig, Germany More articles by this author , Jochen NeuhausJochen Neuhaus Department of Urology, University of Leipzig, Leipzig, Germany More articles by this author , Florian WeberFlorian Weber Department of Pathology, University of Regensburg, Regensburg, Germany More articles by this author , Rudolf FuchshoferRudolf Fuchshofer Institute of Human Anatomy and Embryology, University of Regensburg, Regensburg, Germany More articles by this author , Maximilian BurgerMaximilian Burger Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany More articles by this author , and Johannes BründlJohannes Bründl Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.10.001AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Studies of male pelvic neuroanatomy are mandatory to improve functional outcome after radical prostatectomy. We performed a topographical investigation of nerves on the course from the seminal vesicles along the prostate toward the striated urethral sphincter. Materials and Methods: Serial whole mount sections (1 mm intervals) of pelvic blocks of human adult male autopsy cadavers were investigated after immunohistochemical nerve staining. Computerized nerve quantification and planimetry of the total nerve surface area were performed within defined regions (ventral, ventrolateral, dorsolateral and dorsal) at the levels of the seminal vesicles and prostate, and at the striated urethral sphincter. The distance between the seminal vesicles and the nerves was measured. For improved topographical understanding 3-dimensional reconstructions were created. Differences between 3 independent variables were tested with the nonparametric Kruskal-Wallis test. Results: We studied a total of 969 whole mount sections of 5 cadavers. Nerves were arranged in a vertical plate lateral to the seminal vesicles. Mean ± SD distance to the seminal vesicles was 1.68 ± 0.84, 1.50 ± 0.12 and 1.76 ± 0.37 mm at the tip, middle and base, respectively. Periprostatic nerves were mainly found dorsolaterally. At the striated urethral sphincter 38.9% of nerves had shifted to the dorsal region. The total nerve surface area decreased significantly from the seminal vesicle tip (50.2 mm2) to the striated urethral sphincter level (13.3 mm2) (p = 0.0004). Conclusions: Our findings underline that during nerve sparing prostatectomy nerve damage might occur during mobilization of the entire seminal vesicles, apical dissection and posterior reconstruction of the rhabdosphincter. Nerve planimetry revealed that 75% of the nerves from the seminal vesicles do not reach the striated urethral sphincter level and seem to innervate structures other than the corpora cavernosa. References 1 : Impotence following radical prostatectomy: insight into etiology and prevention. J Urol1982; 128: 492. 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Urology2014; 83: 641. Google Scholar © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byGilbert S, Dunn R, Miller D, Montgomery J, Skolarus T, Weizer A, Wood D and Hollenbeck B (2017) Functional Outcomes Following Nerve Sparing Prostatectomy Augmented with Seminal Vesicle Sparing Compared to Standard Nerve Sparing Prostatectomy: Results from a Randomized Controlled TrialJournal of Urology, VOL. 198, NO. 3, (600-607), Online publication date: 1-Sep-2017.Asimakopoulos A, Campagna A, Gakis G, Corona Montes V, Piechaud T, Hoepffner J, Mugnier C and Gaston R (2016) Nerve Sparing, Robot-Assisted Radical Cystectomy with Intracorporeal Bladder Substitution in the MaleJournal of Urology, VOL. 196, NO. 5, (1549-1557), Online publication date: 1-Nov-2016. Volume 193Issue 4April 2015Page: 1205-1212Supplementary Materials Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordsneuroanatomyprostateurethraprostatectomyseminal vesiclesAcknowledgmentNina Niessl provided technical support.MetricsAuthor Information Roman Ganzer Department of Urology, University of Leipzig, Leipzig, Germany More articles by this author Jens-Uwe Stolzenburg Department of Urology, University of Leipzig, Leipzig, Germany More articles by this author Jochen Neuhaus Department of Urology, University of Leipzig, Leipzig, Germany More articles by this author Florian Weber Department of Pathology, University of Regensburg, Regensburg, Germany More articles by this author Rudolf Fuchshofer Institute of Human Anatomy and Embryology, University of Regensburg, Regensburg, Germany More articles by this author Maximilian Burger Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany More articles by this author Johannes Bründl Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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