Baseline Erectile Function Alters the Cavernous Nerve Quantity and Distribution Around the Prostate

Hisasue, Shin‐ichi; Hashimoto, Kimio; Kobayashi, Ko; Takeuchi, Mio; Kyoda, Youki; Sato, Syozo; Masumori, Naoya; Tsukamoto, Taiji

doi:10.1016/j.juro.2010.06.108

Cited by 18 publications

(21 citation statements)

References 28 publications

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“…Kiyoshima et al [6] reported that, in 79 surgically obtained specimens, DF was fused with the prostatic capsule at the center of the prostatic posterior aspect in 97% of cases. Hisasue et al [15] reported the distribution of neuronal nitric oxide synthase positive nerve fibers, which are candidates for parasympathetic pro-erectile nerves [16]. They found that the distribution of these nerve fibers at 5- to 6-o’clock positions on the base of the prostate was 13.4% in the same hemisphere slice around the prostate in 23 specimens from non-nerve-sparing radical prostatectomy.…”

Section: Discussionmentioning

confidence: 99%

Site-dependent and interindividual variations in Denonvilliers’ fascia: a histological study using donated elderly male cadavers

et al. 2015

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BackgroundSite-dependent and interindividual histological differences in Denonvilliers’ fascia (DF) are not well understood. This study aimed to examine site-dependent and interindividual differences in DF and to determine whether changes in the current approach to radical prostatectomy are warranted in light of these histological findings.MethodsTwenty-five donated male cadavers (age range, 72–95 years) were examined. These cadavers had been donated to Sapporo Medical University for research and education on human anatomy. Their use for research was approved by the university ethics committee. Horizontal sections (15 cadavers) or sagittal sections (10 cadavers) were prepared at intervals of 2–5 mm for hematoxylin and eosin staining. Elastic–Masson staining and immunohistochemical staining were also performed, using mouse monoclonal anti-human alpha-smooth muscle actin to stain connective tissues and mouse monoclonal anti-human S100 protein to stain nerves.ResultsWe observed that DF consisted of disorderly, loose connective tissue and structures resembling “leaves”, which were interlacing and adjacent to each other, actually representing elastic or smooth muscle fibers. Variations in DF were observed in the following: 1) configuration of multiple leaves, including clear, unclear, or fragmented behind the body and tips of the seminal vesicles, depending on the site; 2) connection with the lateral pelvic fascia at the posterolateral angle of the prostate posterior to the neurovascular bundles, being clear, unclear, or absent; 3) all or most leaves of DF fused with the prostatic capsule near the base of the seminal vesicles, and periprostatic nerves were embedded in the leaves at the fusion site; and 4) some DF leaves fused with the prostatic capsule anteriorly and/or the fascia propria of the rectum posteriorly.ConclusionsSite-dependent and interindividual variations in DF were observed in donated elderly male cadavers. All or most DF leaves are fused with the prostatic capsule near the base of the seminal vesicles and some DF leaves are fused with the fascia propria of the rectum posterior. Based on our results, surgeons should be aware of variations and search for them to create a suitable dissection plane to avoid iatrogenic positive margins and rectal injury.

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Section: Discussionmentioning

confidence: 99%

Site-dependent and interindividual variations in Denonvilliers’ fascia: a histological study using donated elderly male cadavers

et al. 2015

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“…Their relatively simple reconstructions suggested that the amounts of adult periprostatic nNOS-positive nerves are likely to be underdeveloped. Because of the wide distribution of nNOS-positive nerves along and around the prostate, some researchers have considered that the cavernous nerve in males should form a network along the prostatic surface rather than within a neurovascular bundle [6, 37, 38]. Because these researchers only stained nerves along the prostate, this seemed to facilitate easy identification of the cavernous nerves or their network.…”

Section: Discussionmentioning

confidence: 99%

“…Immunohistochemical discrimination between the sympathetic and parasympathetic nerves in the human pelvic plexus or its branches has usually been performed using specimens surgically removed from human adults [1, 2, 3, 4, 5, 6] or fetuses [7, 8]. Butler-Manuel et al [3, 4] provided particularly elegant photos of the upper part of the pelvic plexus near the sacral promontory after various types of immunostaining.…”

Section: Introductionmentioning

confidence: 99%

Topohistology of sympathetic and parasympathetic nerve fibers in branches of the pelvic plexus: an immunohistochemical study using donated elderly cadavers

et al. 2014

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Although the pelvic autonomic plexus may be considered a mixture of sympathetic and parasympathetic nerves, little information on its composite fibers is available. Using 10 donated elderly cadavers, we investigated in detail the topohistology of nerve fibers in the posterior part of the periprostatic region in males and the infero-anterior part of the paracolpium in females. Neuronal nitric oxide synthase (nNOS) and vasoactive intestinal polypeptide (VIP) were used as parasympathetic nerve markers, and tyrosine hydroxylase (TH) was used as a marker of sympathetic nerves. In the region examined, nNOS-positive nerves (containing nNOS-positive fibers) were consistently predominant numerically. All fibers positive for these markers appeared to be thin, unmyelinated fibers. Accordingly, the pelvic plexus branches were classified into 5 types: triple-positive mixed nerves (nNOS+, VIP+, TH+, thick myelinated fibers + or -); double-positive mixed nerves (nNOS+, VIP-, TH+, thick myelinated fibers + or -); nerves in arterial walls (nNOS-, VIP+, TH+, thick myelinated fibers-); non-parasympathetic nerves (nNOS-, VIP-, TH+, thick myelinated fibers + or -); (although rare) pure sensory nerve candidates (nNOS-, VIP-, TH-, thick myelinated fibers+). Triple-positive nerves were 5-6 times more numerous in the paracolpium than in the periprostatic region. Usually, the parasympathetic nerve fibers did not occupy a specific site in a nerve, and were intermingled with sympathetic fibers. This morphology might be the result of an "incidentally" adopted nerve fiber route, rather than a target-specific pathway.

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“…TH is a rate-limiting enzyme of catecholamine synthesis in sympathetic ganglion cells, whereas nNOS is a key enzyme in the production of nitric oxide, a molecule that directly regulates vasorelaxation and blood supply, and a well-known marker of parasympathetic neurons. In humans, nNOS reactivity has been investigated particularly in the pelvic nerves [6,7] but previous descriptions for the head region have been limited to the cranial ganglia of the autonomic nervous system [8,9].…”

Section: Introductionmentioning

confidence: 99%

A ganglion cell cluster along the glossopharyngeal nerve near the human palatine tonsil

Oda¹,

Takanashi²,

Katori³

et al. 2013

Acta Oto-Laryngologica

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Near the palatine tonsil, the lingual branches of the glossopharyngeal nerve often contained ganglion cells (in 9 of 12 specimens). The ganglion cells, 20-40 µ in diameter, were sparsely distributed along a 0.5-3.0 mm length of the nerve course attached to the posterolateral aspect of the superior pharyngeal constrictor. Most of these cells were positive for neuronal nitric oxide synthase, while some were positive for tyrosine hydroxylase. Thus, the ganglion was composed of a mixed population of sympathetic and parasympathetic neurons.

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Baseline Erectile Function Alters the Cavernous Nerve Quantity and Distribution Around the Prostate

Abstract: Baseline erectile function greatly impacts cavernous nerve quantity and distribution. Cavernous nerve preservation in the neurovascular bundle, especially at the apex, is still essential for patients with erectile dysfunction.

Cited by 18 publications

References 28 publications

Site-dependent and interindividual variations in Denonvilliers’ fascia: a histological study using donated elderly male cadavers

Site-dependent and interindividual variations in Denonvilliers’ fascia: a histological study using donated elderly male cadavers

Topohistology of sympathetic and parasympathetic nerve fibers in branches of the pelvic plexus: an immunohistochemical study using donated elderly cadavers

A ganglion cell cluster along the glossopharyngeal nerve near the human palatine tonsil

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