Gianduzzo Troy Richard John, Colombo Jose R, El-Gabry Ehab, Haber Georges-Pascal, Gill Inderbir S
Section of Laparoscopic and Robotic Surgery, Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
J Urol. 2008 May;179(5):2025-9. doi: 10.1016/j.juro.2007.12.041. Epub 2008 Mar 20.
Although the dog is often used as a radical prostatectomy model, precise descriptions of canine prostate and neurovascular bundle anatomy are lacking. We describe canine prostate and neurovascular bundle anatomical and electrophysiological characteristics.
The canine prostate and pelvic neurovascular structures were dissected in 6 canine cadavers and 12 anesthetized dogs. Pelvic plexus branches were stimulated using a CaverMap probe and peak intracavernous pressure responses were recorded as a percent of mean arterial pressure.
The canine pelvic plexus lies 5 to 10 mm lateral to the prostate. It is supplied by the hypogastric nerve cranially and the pelvic nerve laterally. The neurovascular bundles course distal from the pelvic plexus along the posterolateral aspect of the prostate, including a dominant cavernous nerve along its lateral aspect. CaverMap stimulation of the efferent branches of the pelvic plexus confirmed their roles in tumescence. Histology revealed extensive neurovascular tissue along the posterolateral aspect of the prostate beneath the periprostatic fascia. Notable differences to human anatomy were the absence of seminal vesicles, the lateral positions of the pelvic plexus, the dominant cavernous nerve and the circumferential urethral distribution of the cavernous nerves.
Canine neurovascular anatomy resembles that of humans and it is a suitable model in which to assess prostatectomy related erectile dysfunction. However, there are key differences in neurovascular relationships that must be considered when the canine prostate is used as a radical prostatectomy model.
尽管犬类常被用作根治性前列腺切除术的模型,但对犬前列腺和神经血管束解剖结构缺乏精确描述。我们描述犬前列腺和神经血管束的解剖及电生理特征。
在6具犬类尸体和12只麻醉犬身上解剖犬前列腺和盆腔神经血管结构。使用CaverMap探头刺激盆腔丛分支,并记录海绵体内压力峰值反应,以平均动脉压的百分比表示。
犬盆腔丛位于前列腺外侧5至10毫米处。它由颅侧的腹下神经和外侧的盆神经供应。神经血管束从盆腔丛沿前列腺后外侧向远端走行,包括沿其外侧的一条主要海绵体神经。CaverMap对盆腔丛传出分支的刺激证实了它们在勃起中的作用。组织学显示,在前列腺周围筋膜下方的前列腺后外侧有广泛的神经血管组织。与人体解剖结构的显著差异在于没有精囊、盆腔丛的外侧位置、主要海绵体神经以及海绵体神经的环形尿道分布。
犬神经血管解剖结构与人类相似,是评估前列腺切除术后勃起功能障碍的合适模型。然而,当将犬前列腺用作根治性前列腺切除术模型时,必须考虑神经血管关系的关键差异。