Review

Asian Journal of Andrology (2005) 7, 339–349; doi:10.1111/j.1745-7262.2005.00097.x

Recent neuroanatomical studies on the neurovascular bundle of the prostate and cavernosal nerves: clinical reflections on radical prostatectomy

Selcuk Yucel, Tibet Erdogru and Mehmet Baykara

Department of Urology, Akdeniz University School of Medicine, Kampus 07070, Antalya, Turkey

Correspondence: Dr Selcuk Yucel, MD, Department of Urology, Akdeniz University School of Medicine, Kampus 07070, Antalya, Turkey. Fax: +90-242-227-4482. E-mail: syucel@akdeniz.edu.tr

Received 24 February 2005; Accepted 22 June 2005.

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Abstract

The neurovascular bundle of the prostate and cavernosal nerves have been used to describe the same structure ever since the publication of the first studies on the neuroanatomy of the lower urogenital tract of men, studies that were prompted by postoperative complications arising from radical prostatectomy. In urological surgery every effort is made to preserve or restore the neurovascular bundle of the prostate to avoid erectile dysfunction (ED). However, the postoperative potency rates are yet to be satisfactory despite all advancements in radical prostatectomy technique. As the technology associated with urological surgery develops and topographical studies on neuroanatomy are cultivated, new observations seriously challenge the classical teachings on the topography of the neurovascular bundle of the prostate and the cavernosal nerves. The present review revisits the classical and most recent data on the topographical anatomy of the neurovascular bundle of the prostate and cavernosal nerves and their implications on radical prostatectomy techniques.

Keywords:

prostate cancer, cavernosal nerves, neurovascular bundle, neuroanatomy, prostatectomy, laparoscopy, robotics, nerve graft, penile erection

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