Revisiting anatomical landmarks of cadaveric nerve-sparing radical prostatectomy in accordance to Terminologia Anatomica

Abstract

Objectives: Because of the developing and standardizing urology resident education, we aimed to show important anatomical landmarks of nerve-sparing radical prostatectomy in a cadaveric dissection. Methods:The steps of the dissection were; 1) Incision of pelvic fascia, 2) Dissection of the puboprostatic complex, 3) Dissection of the urethral sphincteric complex and apical dissection of the prostate and urethra, 4) Dissection of the posterior part of the prostate, 5) Preservation of the neurovascular bundle (included the cavernous nerve of the penis), pedicle dissection, and 6) Dissection of bladder neck, seminal vesicle and ductus deference. Results:At the end of the dissection, proved anatomical landmarks were; 1) parietal pelvic fascia, tendinous arc, internal obturator fascia, 2) puboprostatic ligament, pubic symphysis, deep dorsal penile vein, 3) external urethral sphincter, levator ani muscle, neurovascular bundle, 4) rectoprostatic fascia, seminal vesicles, perirectal fat tissue, 5) cavernous nerve, capsular artery and vein, levator fascia, periprostatic fascia, prostatic capsule, 6) Bladder neck, deferent duct, detrusor apron. Conclusion:Uniformity of terminology and identical definitions of structures in both cadaveric dissection and surgery might help to improve comprehensibility of anatomical and surgical knowledge of the young urological surgeons and anatomists.

Novel anatomical identification of nerve-sparing radical prostatectomy: fascial-sparing radical prostatectomy

“…Nielsen et al [ 16 ] reported excellent oncological results and improved postoperative sexual function after this technique. I suggest that working collaboratively with a clinical anatomist is crucial to update the anatomical terminology of the prostate, which contiguous structures are clinically useful, and the surgical procedure [ 56 ].…”