Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

A cadaveric histological investigation of the prostate with three-dimensional reconstruction for better results in continence and erectile function after radical prostatectomy

Prostate Cancer and Prostatic Diseases volume 10, pages 77–81 (2007)Cite this article

Abstract

In this study our aim is to increase the understanding of the prostate and related organs anatomy for better continence and erectile function results after urological surgery. Prostate and related organs were dissected from seven cadavers. After dissection, 165 serial sections with 300 μm thickness were derived at a 100 μm interval. The histological images were examined and imported to the computer. Three-dimensional (3D) remodeling had been performed. The findings were evaluated into three categories: macroscopic, microscopic and 3D reconstruction. Striated muscle fibers had been detected at the anterior fibromuscular stroma in histological sections. In 3D remodeling, urethra seemed to be a complete functional unit, beginning from the trigone up to the membranous urethra. The neurovascular bundles run under the pelvic fascia on both sides and go through to the bladder neck at 5 and 7 o’clock. Computer remodeling demonstrated that neurovascular structures had a close association with the bladder neck and the seminal vesicle. Computer program made it possible to rotate all 3D-reconstructed figures by 360° and examine them from all possible angles. All reconstructed structures can be examined together at the same time or one by one. Surgeons must pay special attention to the continence area described as a single unit, beginning from trigone to the membranous urethra, during the surgery. Meticulous dissection of the neurovascular bundles, especially close to the seminal vesicles and bladder neck, during the radical prostatectomy is necessary. These reconstructions can be used for the educational purpose of medical students as well as the urology surgeons.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Brooks JD, Chao WM, Kerr J . Male pelvic anatomy reconstructed from the Visible Human data set. J Urol 1998; 159: 868–873.

    Article  CAS  Google Scholar 

  2. Myers RP . Practical surgical anatomy for radical prostatectomy. Urol Clin N Am 2001; 28: 473–492.

    Article  CAS  Google Scholar 

  3. Jemal A, Siegel R, Ward E, Murray T, Xu J, Smigal C et al. Cancer statistics. CA Cancer J Clin 2006; 56: 106–130.

    Article  Google Scholar 

  4. Eskicorapci SY, Karabulut E, Türkeri L, Baltaci S, Cal C, Toktas G et al. Validation of 2001 Partin tables in Turkey: a multicenter study. Eur Urol 2005; 47: 185–189.

    Article  Google Scholar 

  5. Trelease RB . Anatomical informatics: millennial perspectives on a never frontier. Anatom Rec (New Anat) 2002; 269: 224.

    Article  Google Scholar 

  6. McNeal JE . The prostate gland: morphology and pathobiology. Monogr Urol 1988; 9: 36.

    Google Scholar 

  7. Catalona WJ, Smith DS, Ratliff TL, Basler JW . Detection of organ-confined prostate cancer is increased through prostate-specific antigen-based screening. JAMA 1993; 270: 948.

    Article  CAS  Google Scholar 

  8. Kundu SD, Roehl KA, Eggener SE, Antenor JA, Han M, Catalona WJ . Potency, continence and complications in 3,477 consecutive radical retropubic prostatectomies. J Urol 2004; 172 (Part 1): 2227.

    Article  Google Scholar 

  9. Meuleman EJ, Mulders PF . Erectile function after radical prostatectomy: a review. Eur Urol 2003; 43: 95.

    Article  CAS  Google Scholar 

  10. Walsh PC, Marschke P, Ricker D, Burnett AL . Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. Urology 2000; 55: 58.

    Article  CAS  Google Scholar 

  11. Cathelineau X, Rozet F, Vallancien G . Robotic radical prostatectomy: the European experience. Urol Clin N Am 2004; 31: 693–699.

    Article  Google Scholar 

  12. Yucel S, Baskin LS . An anatomical description of the male and female urethral sphincter complex. J Urol 2004; 171: 1890.

    Article  Google Scholar 

  13. Lapides J, Sweet RB, Lewis LW . Role of striated muscle in urination. J Urol 1957; 77: 247.

    Article  CAS  Google Scholar 

  14. Tanagho EA, Meyers FH, Smith DR . Urethral resistance: its components and implications. Smooth muscle component. Invest Urol 1969; 2: 136.

    Google Scholar 

  15. Tanagho EA, Meyers FH, Smith DR . Urethral resistance: its components and implications. Striated muscle component. Invest Urol 1969; 7: 195.

    CAS  PubMed  Google Scholar 

  16. Steiner MS . Continence-preserving anatomic radical retropubic prostatectomy. Urology 2000; 55: 427.

    Article  CAS  Google Scholar 

  17. Karam I, Droupy S, Abd-Alsamad I, Korbage A, Uhl JF, Benoit G et al. The precise location and nature of the nerves to the male human urethra: histological and immunohistochemical studies with three-dimensional reconstruction. Eur Urol 2005; 48: 858.

    Article  Google Scholar 

  18. Takenaka A, Murakami G, Soga H, Han SH, Arai Y, Fujisawa M . Anatomic analysis of the neurovascular bundle supplying penile cavernous tissue to ensure a reliable nerve graft after radical prostatectomy. J Urol 2004; 172: 1032.

    Article  Google Scholar 

  19. Eastham JA, Kattan MW, Rogers E, Goad JR, Ohori M, Boone TB et al. Risk factors for urinary incontinence after radical prostatectomy. J Urol 1996; 156: 1707–1713.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anatomy, Faculty of Medicine, Pamukkale University, Denizli, Turkey

    M B Özdemir

  2. Department of Urology, Faculty of Medicine, Pamukkale University, Denizli, Turkey

    S Y Eskicorapci

  3. Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    D E Baydar

  4. Department of Anatomy, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    M Cumhur & S Önderoğlu

  5. Department of Urology, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    H Özen

Authors
  1. M B Özdemir
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S Y Eskicorapci
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D E Baydar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M Cumhur
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S Önderoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. H Özen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S Y Eskicorapci.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Özdemir, M., Eskicorapci, S., Baydar, D. et al. A cadaveric histological investigation of the prostate with three-dimensional reconstruction for better results in continence and erectile function after radical prostatectomy. Prostate Cancer Prostatic Dis 10, 77–81 (2007). https://doi.org/10.1038/sj.pcan.4500917

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.pcan.4500917

Keywords

Search

Advanced search

Quick links