Abdalla Abdelrahman S, Chen Henry, Kolawole Fikunwa O, Nolley Rosalie, Kao Chia-Sui, Dobberfuhl Amy D, Gill Harcharan S
Department of Internal Medicine, AdventHealth, Sebring, FL, 33870, USA.
Department of Urology, Center for Academic Medicine, Urology-5656, Stanford University School of Medicine, 453 Quarry Road, Palo Alto, CA, 94304, USA.
World J Urol. 2025 Apr 3;43(1):209. doi: 10.1007/s00345-025-05578-5.
There are limited studies describing the contractile function of the endopelvic fascia in the male pelvis and the role of the endopelvic fascia in the pathophysiology of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). We performed ex-vivo functional studies and described the histology of the endopelvic fascia.
Endopelvic fascia specimens were collected from patients (n = 10) undergoing robotic prostatectomy. Two fascia strips (2 × 1 cm) from each side of the pelvis were excised and immediately used for functional studies. Each strip was cut into one centimeter piece for studying. One strip was suspended in organ baths and contractile response to potassium chloride (100 mM), and carbachol (0.01 µM, 1 µM, 10 µM, 20 µM) assessed. The second strip was used for histology with hematoxylin and eosin (H&E) and Masson-trichrome staining for elastic fibers, collagen and smooth muscle or stress strain testing.
Twenty endopelvic fascia samples from 10 patients were analyzed. Only two specimens showed a contractile response to potassium chloride. The remaining 18 specimens exhibited no contractile response. Histologically, the fascia consisted mainly of fibrous connective tissue with minor adipose tissue and occasional smooth muscle, along with arterioles. Tensile testing revealed nonlinear behavior, with a nominal stiffness estimated at 0.765 MPa after the toe region.
The male endopelvic fascia lacks contractile response to potassium chloride and cholinergic stimulation, resembling other human fasciae histologically. It's improbable that it contributes to male LUTS but may impede prostate expansion mechanically due to its fibrous nature.
关于男性盆腔内筋膜的收缩功能以及盆腔内筋膜在良性前列腺增生（BPH）继发下尿路症状（LUTS）病理生理学中的作用的研究有限。我们进行了体外功能研究并描述了盆腔内筋膜的组织学特征。
从接受机器人前列腺切除术的患者（n = 10）中收集盆腔内筋膜标本。从骨盆两侧各切除两条筋膜条（2×1厘米），并立即用于功能研究。将每条筋膜条切成1厘米的片段进行研究。一条筋膜条悬挂在器官浴中，评估其对氯化钾（100 mM）和卡巴胆碱（0.01 μM、1 μM、10 μM、20 μM）的收缩反应。第二条筋膜条用于苏木精和伊红（H&E）染色以及弹性纤维、胶原蛋白和平滑肌的马松三色染色或应力应变测试的组织学检查。
分析了来自10名患者的20个盆腔内筋膜样本。只有两个标本对氯化钾有收缩反应。其余18个标本没有收缩反应。组织学上，筋膜主要由纤维结缔组织组成，伴有少量脂肪组织和偶尔的平滑肌，以及小动脉。拉伸测试显示出非线性行为，在趾区之后的标称刚度估计为0.765 MPa。
男性盆腔内筋膜对氯化钾和胆碱能刺激缺乏收缩反应，在组织学上与其他人体筋膜相似。它不太可能导致男性LUTS，但由于其纤维性质可能会在机械上阻碍前列腺扩张。
