Significance of Neurovascular Bundle Formation Observed on Preoperative Magnetic Resonance Imaging Regarding Postoperative Erectile Function After Nerve-Sparing Radical Retropubic Prostatectomy

Lee, Sang Eun; Hong, Sung Kyu; Han, June Hyun; Han, Byoung Hee; Yu, Ji Hyung; Jeong, Sung‐Jin; Byun, Seok‐Soo; Lee, Hak Jong

doi:10.1016/j.urology.2006.11.008

Cited by 41 publications

(18 citation statements)

References 19 publications

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“…[81][82][83] Several studies have shown that use of an endorectal coil during MRI provides improved diag nosis compared with more conventional approaches such as body coils and pelvic phasedarray coils, but with added discomfort to the patient. 82,83 MRI studies utilizing conventional coils and functional endorectal MRI coils have been tested for mapping the cavernous nerves.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

“…82,83 MRI studies utilizing conventional coils and functional endorectal MRI coils have been tested for mapping the cavernous nerves. [81][82][83][84][85][86][87][88] Studies that have used conventional 1.0 T and 1.5 T magnets have shown mixed results, with an inability to detect the neurovascular bundle occurring in a considerable number of patients. [81][82][83][84][85] Use of MRI systems with higher magnetic field strengths, such as 3 T magnets, provide increased sen sitivity, higher resolution for enhanced image quality, and faster image acquisition times (enabling shorter patient scans).…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

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Novel methods for mapping the cavernous nerves during radical prostatectomy

Fried

Burnett

2015

Nat Rev Urol

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The cavernous nerves, which course along the surface of the prostate gland, are responsible for erectile function. During radical prostatectomy, urologists are challenged in preserving these nerves and their function. Cavernous nerves are microscopic and show variable location in different patients; therefore, postoperative sexual potency rates are widely variable following radical prostatectomy. A variety of technologies, including electrical and optical nerve stimulation, dye-based optical fluorescence and microscopy, spectroscopy, ultrasound and magnetic resonance imaging have all been used to study cavernous nerve anatomy and physiology, and some of these methods are also potential intraoperative methods for identifying and preserving cavernous nerves. However, all of these technologies have inherent limitations, including slow or inconsistent nerve responses, poor image resolution, shallow image depth, slow image acquisition times and/or safety concerns. New and emerging technologies, as well as multimodal approaches combining existing methods, hold promise for improved postoperative sexual outcomes and patient quality of life following radical prostatectomy.

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Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Novel methods for mapping the cavernous nerves during radical prostatectomy

Fried

Burnett

2015

Nat Rev Urol

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“…prostate.'' Furthermore, Lee et al (2007) judged preoperative T2-weighted magnetic resonance images in axial section in 93 patients, who subsequently underwent bilateral NVB-sparing surgery. They found three groups: group 1, no definite NVB at the posterolateral prostate; group 2, ''probable'' NVB at the posterolateral prostate; and group 3, NVB ''clearly observed'' at posterolateral prostate (as in Fig.…”

Section: Contiguous Structures Neurovascular Bundlementioning

confidence: 99%

Making anatomic terminology of the prostate and contiguous structures clinically useful: Historical review and suggestions for revision in the 21st Century

2009

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Herein we review nomenclature of the prostate and contiguous structures in each of the 10 official publications from the 1895 [Basel] Nomina Anatomica to the 1998 Terminologia Anatomica. We then compare existing clinical terminology with official terminology endorsed by anatomists over the years with a goal to modernize official terminology. Problematic terms, namely, lobes and lobuli, fascia versus capsule, Denonvilliers' fascia, and transition versus periurethral zone, are addressed. The idea of recognizing prostate arteries, veins, nerves, and neurovascular bundles is introduced. Prostatic and membranous urethras and the closely related external urethral sphincter are covered. We believe urogenital hiatus should also be called anterior levator hiatus. Trapezoid zone should be discarded in future editions of nomenclature. Our recommended changes are supported by a series of pertinent photographs of gross and whole mount histologic specimens and magnetic resonance images. Finally, we provide a new table of terms for the prostate with recommended amendments and deletions to existing official nomenclature as contained in the 1998 Terminologia Anatomica.

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“…Encontraron una relación entre el empeoramiento del Índice Internacional de Función Eréctil, IIFF-5, y la ausencia del FNVLP en la RMN, lo que pudiera suponer que estos pacientes no tienen un fascículo definido sino que los nervios cavernosos se sitúan dispersamente sobre la superficie antero-lateral de la próstata 27 .…”

Section: Actas Urológicas Españolasunclassified

Controversias en la anatomía quirúrgica prostática: Revisión de la literatura

Gardiner¹,

Amo

Benavente³

et al. 2009

Actas Urol Esp

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ResumenIntroducción: La técnica para la prostatectomía radical ha evolucionado dinámicamente durante los últimos años en base a una mayor experiencia quirúrgica acumulada y descubrimientos anatómicos. Nos parece oportuno revisar y actualizar algunos conceptos anatómicos básicos que nos permita conseguir una uniformidad de criterios y términos al referirnos a esta técnica quirúrgica. Material y Método:Hemos realizado una búsqueda bibliográfica en Medline/PubMed. Palabras clave: cavernosal nerves, prostatectomy, anatomy, neurovascular bundle. Realizamos una lectura detallada de los resúmenes de los artículos obtenidos, seleccionando aquellos que se ajustaban a los diferentes temas fijados para la revisión Conclusiones: La glándula prostática no posee una cápsula verdadera sino que esta representada por una banda fibromuscular incompleta que es intrínseca a la glándula. La fascia periprostática parece ser una estructura distinta de esta banda fibromuscular.La Fascia de Denonvilliers en una fascia histológicamente compuesta por dos láminas pero quirúrgicamente indistinguibles. Las fibras ubicadas longitudinalmente por debajo del labio posterior del cuello vesical parecen corresponder a la fascia longitudinal posterior que pertenece al músculo detrusor. Los nervios cavernosos se sitúan entre dos hojas de la fascia endopélvica que podríamos denominar fascia periprostática (más interna) y fascia del elevador (más externa). Los nervios cavernosos son eferencias del plexo pélvico y se ubican dentro de un fascículo neurovascular con distribución variable alrededor de la próstata según cada individuo (fascículo único o dispersos por la superficie anterolateral de la próstata).Consideramos conveniente que la comunidad de Urólogos unifique los términos para denominar las fascias pélvicas y evitar superposición de términos.Palabras clave: Nervios cavernosos. Prostatectomía. Anatomía. Fascículo neurovascular. Controversies in the Prostate Surgical Anatomy. A literature review AbstractIntroduction: Radical prostatectomy technique has improved in the last years based on accumulated surgical expe-

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Significance of Neurovascular Bundle Formation Observed on Preoperative Magnetic Resonance Imaging Regarding Postoperative Erectile Function After Nerve-Sparing Radical Retropubic Prostatectomy

Cited by 41 publications

References 19 publications

Novel methods for mapping the cavernous nerves during radical prostatectomy

Novel methods for mapping the cavernous nerves during radical prostatectomy

Making anatomic terminology of the prostate and contiguous structures clinically useful: Historical review and suggestions for revision in the 21st Century

Controversias en la anatomía quirúrgica prostática: Revisión de la literatura

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