Retroperitoneal adrenalectomy is a reliable and effective technique. At our institution retroperitoneal laparoscopy is now the standard adrenal surgery procedure for tumors less than 5 cm.

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Classically, the peripheral neural pathways for erection are proerectile, issuing from the parasympathetic sacral fibres, and antierectile from the thoracolumbar sympathetic trunk. The cavernous nerves as terminal branches of the pelvic plexus convey the parasympathetic fibres to the penis. The pudendal nerve conveys sensory fibres from the penis and somatic fibres to the bulbos-pongiosus and ischiocavernosus striated mm. In animals, it has been demonstrated that the dorsal nerve of the penis contains sympathetic fibres. These findings suggest that communicating branches exist between the cavernous nerves and the dorsal nerve. Our aim in this study was to demonstrate the presence of such connections in man. We dissected 20 fresh male cadavers. The pelvic plexus and pudendal nerves were dissected to identify their terminal branches and connections. Histologic study was performed. Our results showed evidence of communicating nervous branches between the cavernous nerves and the dorsal nerve of the penis. Several variants existed concerning the number and type of connections. The presence of such communicating branches proves that the supralevator and infralevator neural pathways communicate and suggest the possibility of a kind of plasticity of the nervous supply of penile erection. Further studies are needed to identify the nature of these communicating branches.

No abstract