J Korean Med Sci.  2010 Apr;25(4):608-612. 10.3346/jkms.2010.25.4.608.

Neuroanatomical Study of Periprostatic Nerve Distributions Using Human Cadaver Prostate

Affiliations
  • 1Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea. sgchang@khu.ac.kr
  • 2Department of Pathology, School of Medicine, Kyung Hee University, Seoul, Korea.

Abstract

We investigated the distribution and navigation of periprostatic nerve fibers and constructed a 3-dimensional model of nerve distribution. A total of 5 cadaver specimens were serially sectioned in a transverse direction with 0.5 cm intervals. Hematoxylineosin staining and immunohistochemical staining were then performed on whole-mount sections. Three representative slides from the base, mid-part, and apex of each prostate were subsequently divided into 4 sectors: two lateral, one ventral, and one dorsal (rectal) part. The number of nerve fibers, the distance from nerve fiber to prostate capsule, and the nerve fiber diameters were analyzed on each sector from the representative slides by microscopy. Periprostatic nerve fibers revealed a relatively even distribution in both lateral and dorsal parts of the prostate. There was no difference in the distances from the prostate capsule to nerve fibers. Nerve fibers in the ventral area were also thinner as compared to other areas. In conclusion, periprostatic nerve fibers were observed to be distributed evenly in the periprostatic area, with the exception of the ventral area. As the number of nerve fibers on the ventral part is fewer in comparison, an excessive high up incision is insignificant during the nerve-sparing radical prostatectomy.

Keyword

Neurovascular Bundle; Prostate Neoplasms; Radical Prostatectomy

MeSH Terms

Adult
Aged
*Cadaver
Humans
Image Processing, Computer-Assisted
Imaging, Three-Dimensional
Male
Middle Aged
*Models, Anatomic
Neuroanatomy
Peripheral Nerves/*anatomy & histology
Prostate/*innervation
Prostatectomy/methods
Prostatic Neoplasms/surgery

Figure

  • Fig. 1 Classification into four parts in whole-mount section of prostate with immunochemical staining using anti-S-100 protein antibody (asterix, urethra inserted Foley catheter previously).

  • Fig. 2 Histological section showing nerve distributions at ventral (A), dorsal (rectal, B), right lateral (C), and left lateral (D) parts. Nerve fibers in the ventral part (A) show decreased diameter and number compared to other parts (original magnification ×40, arrow, nerve fibers stained with anti-S-100 protein antibody).

  • Fig. 3 A 3-dimensional model of navigation of periprostatic nerve fibers made by connection of silks.


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