A cadaveric histological investigation of the prostate with three-dimensional reconstruction for better results in continence and erectile function after radical prostatectomy

Abstract

In this study our aim is to increase the understanding of the prostate and related organs anatomy for better continence and erectile function results after urological surgery. Prostate and related organs were dissected from seven cadavers. After dissection, 165 serial sections with 300 lm thickness were derived at a 100 lm interval. The histological images were examined and imported to the computer. Three-dimensional (3D) remodeling had been performed. The findings were evaluated into three categories: macroscopic, microscopic and 3D reconstruction. Striated muscle fibers had been detected at the anterior fibromuscular stroma in histological sections. In 3D remodeling, urethra seemed to be a complete functional unit, beginning from the trigone up to the membranous urethra. The neurovascular bundles run under the pelvic fascia on both sides and go through to the bladder neck at 5 and 7 o'clock. Computer remodeling demonstrated that neurovascular structures had a close association with the bladder neck and the seminal vesicle. Computer program made it possible to rotate all 3D-reconstructed figures by 3601 and examine them from all possible angles. All reconstructed structures can be examined together at the same time or one by one. Surgeons must pay special attention to the continence area described as a single unit, beginning from trigone to the membranous urethra, during the surgery. Meticulous dissection of the neurovascular bundles, especially close to the seminal vesicles and bladder neck, during the radical prostatectomy is necessary. These reconstructions can be used for the educational purpose of medical students as well as the urology surgeons.

Application of Dried Human Amnion Graft to Improve Post-Prostatectomy Incontinence and Potency: A Randomized Exploration Study Protocol

“…A fast healing of the muscle and fine nerve branches in this area would lead to a better functional outcome and early recovery of continency and potency after RP. This has been shown by several studies (IDEAL stage 1-2b) [36,37].…”

Analysis of Anatomical Factors Contributing to Urinary Incontinence After Radical Prostatectomy (Literature Review)

“…тобто, попередження травмування нВП принаймні приводить до раннього відновлення континенції після радикальної простатектомії. Це було доведено численними високоякісними дослідженнями [5,29,[37][38][39][40]. незважаючи на зазначене вище, деякі автори не згодні з наведеними висновками та вважають, що не існує будь-якої різниці у результатах континенції між нервозберігаючими та нервонезберігаючими техніками [41].…”

Musculus Sphinchter Urethrae Interna ve Musculus Sphinchter Urethrae Externa Anatomisi

“…Ayrıca burada sadece düz kaslardan bahsedilmiştir, fakat Özdemir ve ark. 2007 yılında yayınladıkları bir yazıda, anterior fibromusculer storomada yaygın çizgili kaslara da rastlamıştır ve bunu rapor etmişlerdir 2 . Şekil 1'de ön fibromusculer stroma erkek sisteminde gösterilmiştir.…”

“…Şekil 1'de ön fibromusculer stroma erkek sisteminde gösterilmiştir. Buradan alınan transvers kesitin histolojik incelemesinde (HE) mesane boynunda çizgili kasların da varlığı saptanmıştır (Şekil 2, 3) 2 . Bu çizgili kasların dağılımı üç boyutlu olarak gösterilmiştir (Şekil 4) [3][4][5] .…”