title: Division of autonomic nerves within the neurovascular bundles distally into corpora cavernosa and corpus spongiosum components: immunohistochemical confirmation with three-dimensional reconstruction.
abstract: BACKGROUND
  Detailed knowledge of the distribution and distal course of periprostatic nerves is essential to improve functional outcomes (erection and continence) after radical prostatectomy (RP).
  
  
  OBJECTIVE
  To describe the location of nerve fibres within neurovascular bundles (NVBs) and around the prostate by three-dimensional (3D) computer-assisted anatomic dissection (CAAD) in human foetuses and adult cadavers.
  
  
  METHODS
  Serial transverse sections of the pelvic portion were performed in seven human male foetuses and four male adult cadavers. Sections were treated by histologic coloration and neuronal immunolabelling of S100 protein. 3D pelvic reconstruction was achieved with digitised serial sections and WinSurf software.
  
  
  METHODS
  We evaluated the distribution of nerve fibres within the NVB qualitatively. The distribution of periprostatic nerves was also evaluated quantitatively in the adult specimens.
  
  
  CONCLUSIONS
  Periprostatic nerve fibres were dispersed around the prostate on all sides with a significant percentage of these fibres present in the anterior and anterolateral sectors. At the prostate apex and the urethral levels, the NVBs have two divisions: cavernous nerves (CNs) and corpus spongiosum nerves (CSNs). The CNs were a continuation of the anterior and anterolateral fibres around the apex of the prostate, travelling towards the corpora cavernosa. The CSNs were a continuation of the posterolateral NVBs, and they eventually reached the corpus spongiosum. The limitations of this study were the small number of specimens available and the lack of functional information.
  
  
  CONCLUSIONS
  The anterolateral position of CNs at the apex of the prostate and the autonomic innervation towards the corpus spongiosum via CSNs indicate possible ways to minimise the effect of prostate surgery on sexual function. The ideal dissection plane should probably include the preservation of the anterolateral tissues and fascias to avoid CN lesions. Anatomic knowledge gained from CAAD pertains directly to proper surgical technique and subsequent recovery of erectile function after RP.
authors.affiliation: Laboratory of Experimental Surgery, EA 4122, Faculty of Medicine, Bicêtre-Paris 11 University, Le Kremlin-Bicêtre, France. drbayan@gmail.com
authors.forename: Bayan
authors.initials: B
authors.lastname: Alsaid
authors.forename: Thomas
authors.initials: T
authors.lastname: Bessede
authors.forename: Djibril
authors.initials: D
authors.lastname: Diallo
authors.forename: David
authors.initials: D
authors.lastname: Moszkowicz
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Karam
authors.forename: Gérard
authors.initials: G
authors.lastname: Benoit
authors.forename: Stéphane
authors.initials: S
authors.lastname: Droupy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017776:Autonomic Pathways / Q000033:anatomy & histology* / Q000737:chemistry / Q000196:embryology; D015415:Biomarkers / Q000032:analysis; D002102:Cadaver; D003196:Computer Graphics; D004210:Dissection / Q000379:methods*; D005865:Gestational Age; D006801:Humans; D007001:Hypogastric Plexus / Q000033:anatomy & histology* / Q000737:chemistry / Q000196:embryology; D021621:Imaging, Three-Dimensional; D007150:Immunohistochemistry; D008297:Male; D010413:Penis / Q000098:blood supply / Q000196:embryology / Q000294:innervation*; D011467:Prostate / Q000098:blood supply / Q000196:embryology / Q000294:innervation*; D009418:S100 Proteins / Q000032:analysis; D012984:Software
chemical_list: D015415:Biomarkers; D009418:S100 Proteins