Extended periprostatic nerve distributions on the prostate surface confirmed using diffusion tensor imaging

Sievert, Karl‐Dietrich; Hennenlotter, Jörg; Dillenburg, T.; Toomey, Patricia; Wöllner, Jens; Zweers, Peter; Pannek, Jürgen; Andersson, Karl‐Erik; Amend, Bastian

doi:10.1111/bju.14508

Cited by 15 publications

(11 citation statements)

References 43 publications

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“…Therefore, irregular hyperplasia of the prostate causes this angular position to change, which may affect the efficacy of anesthesia. Also, some studies found that NVB distribution is variable in some patients, and not all the peripheral nerves of the prostate are located at that angle (24). Hence, there is a need for a method that is sensitive enough to accurately position the NVB, to improve the anesthetic efficacy of PNB.…”

Section: Discussionmentioning

confidence: 99%

The application of a targeted periprostatic nerve block in transperineal template-guided prostate biopsies

Ding

Luan

Wang

et al. 2020

Quant Imaging Med Surg

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Background: Our study aims to evaluate the anesthetic efficacy of multiparametric magnetic resonance imaging/transrectal ultrasound (mpMRI/TRUS) fusion-guided targeted periprostatic nerve block (PNB) for transperineal template-guided prostate biopsy (TTPB). Methods:The patients who underwent mpMRI/TRUS fusion-guided prostate biopsy from May 2018 to March 2019 were randomized into two groups using a random number table. The intervention group (n=47) and the control group (n=45) received targeted PNB and traditional PNB, respectively. Visual analog scale (VAS) and visual numeric scale (VNS) scores were used to assess the patients' pain and quantify their satisfaction.Results: The total detection rate for prostate cancer was 45.7%, with a comparable positive rate between the intervention group (42.6%) and the control group (48.9%), which meant there was no significant difference between the groups (P=0.542). Patient age, prostate-specific antigen, prostate volume, suspicious lesions on mpMRI, number of cores, operation time, and biopsy time were comparable between the groups. The VAS scores during biopsy were significantly lower in the intervention group than in the control group [2 (1 to 3) vs. 2 (1 to 4), P=0.019]. Conversely, the VNS scores during biopsy were higher in the intervention group [3 (2 to 4) vs. 3 (2 to 3), P=0.015]. There were no significant differences in the pain scores or the satisfaction scores at 30 min after the procedure between the two groups. There were no significant differences between the groups for complications, such as hematuria, urinary retention, infection, hemospermia, and vasovagal reaction (P>0.05).Conclusions: Targeted PNB significantly relieved the pain and did not increase the incidence of complications for patients when compared with traditional PNB.

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Section: Discussionmentioning

confidence: 99%

The application of a targeted periprostatic nerve block in transperineal template-guided prostate biopsies

Ding

Luan

Wang

et al. 2020

Quant Imaging Med Surg

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“…The neurogenic contractions induced by EFS reflect the tissue depolarization and consequent neurotransmitter release from the autonomic fibers. In the prostatic tissue from humans and rodents, noradrenaline is the main neurotransmitter released upon neuronal depolarization (Sievert et al, 2019;Pennefatheret al, 2000). This neurotransmitter elicits smooth muscle contraction through post-junctional α1-adrenoceptor stimulation, Gq protein activation and Ca 2+ -IP 3 signaling-based downstream (Michel, Vrydag, 2006).…”

Section: Discussionmentioning

confidence: 99%

“…Prostate smooth muscle is highly innervated by excitatory and inhibitory autonomic neurons, which play a key role in the organ physiology (Sievert et al, 2019). The adrenergic nerves are the main pathway in several species and are responsible for the prostate smooth muscle contraction (Calmasini et al, 2015;…”

Section: Introductionmentioning

confidence: 99%

Aging-associated prostate smooth muscle hypercontractility in rats

Lopes¹,

Fritoli²,

Silva

et al. 2022

Braz. J. Pharm. Sci.

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Benign prostatic hyperplasia (BPH) is a multifactorial disease, highly associated with aging and characterized by increased prostate smooth muscle (PSM) contractility. Animal models have been employed to explore the aging-associated PSM hypercontractility; however, studies have focused in old animals, neglecting the initial alterations in early ages. The determination of prostatic dysfunctions onset is crucial to understand the BPH pathophysiology and to propose new BPH treatments. Considering that PSM contractility in 10-month-old rats has already been explored, the aim of the present study was to characterize the PSM contractility in younger rats. Male Wistar control (3.5-month-old), 6-and 8-month-old rats were used. Concentrationresponse curves to phenylephrine and electrical-field stimulation (EFS) were conducted in prostate from all groups. For the first time, we showed that 6-and 8-month-old rats exhibit PSM hypercontractility. The increased prostate contractility to phenylephrine starts around at 6-month-old, worsening during the aging. The 8-month-old rats exhibited hypercontractility to phenylephrine and EFS compared to the control and 6-month-old groups. Reduced phenylephrine potency was observed in 8-month-old rats, indicating an increased age-dependent prostate sensibility to this agonist. Collectively, our findings support the use of 6-and 8-month-old aged rats as new models to explore prostate hypercontractility in BPH.

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“…In addition, immunostaining of nerve fibers using RP specimens reported that 25% of all nerves were located in the anterolateral and anterior section of the prostate, suggesting that nerve damage is inevitable during RP, although it depends on the degree of NS. It is thought that nerve damage is inevitable during RP [27].…”

Section: Pathophysiology and Anatomy Of Erectile Functionmentioning

confidence: 99%

Impact of Pelvic Anatomical Changes Caused by Radical Prostatectomy

Kadono

Nohara

Kawaguchi

et al. 2022

Cancers

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During radical prostatectomy, the prostate is removed along with the seminal vesicles, and the urinary tract is reconstructed by dropping the bladder onto the pelvic floor and suturing the bladder and urethra together. This process causes damage to the pelvic floor and postoperative complications due to the anatomical changes in the pelvic floor caused by the vesicourethral anastomosis. Urinary incontinence and erectile dysfunction are major complications that impair patients’ quality of life after radical prostatectomy. In addition, the shortening of the penis and the increased prevalence of inguinal hernia have been reported. Since these postoperative complications subsequently affect patients’ quality of life, their reduction is a matter of great interest, and procedural innovations such as nerve-sparing techniques, Retzius space preservation, and inguinal hernia prophylaxis have been developed. It is clear that nerve sparing is useful for preserving the erectile function, and nerve sparing, urethral length preservation, and Retzius sparing are useful for urinary continence. The evaluation of pre- and postoperative imaging to observe changes in pelvic anatomy is also beginning to clarify why these techniques are useful. Changes in pelvic anatomy after radical prostatectomy are inevitable and, therefore, postoperative complications cannot be completely eliminated; however, preserving as much of the tissue and structure around the prostate as possible, to the extent that prostate cancer control is not compromised, may help reduce the prevalence of postoperative complications.

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Extended periprostatic nerve distributions on the prostate surface confirmed using diffusion tensor imaging

Cited by 15 publications

References 43 publications

The application of a targeted periprostatic nerve block in transperineal template-guided prostate biopsies

The application of a targeted periprostatic nerve block in transperineal template-guided prostate biopsies

Aging-associated prostate smooth muscle hypercontractility in rats

Impact of Pelvic Anatomical Changes Caused by Radical Prostatectomy

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