Anatomical localization of the pelvic fascia neural network around the prostate on the cadavers

ZHU Zai-Sheng; SHI Hong-Qi; ZHOU Peng-Fei; XU Li-Zhen; ZHU Yi-Yi; CHEN Jia-Jun

doi:10.16098/j.issn.0529-1356.2020.05.023

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Acta Anatomica Sinica ›› 2020, Vol. 51 ›› Issue (5) : 778-783. DOI: 10.16098/j.issn.0529-1356.2020.05.023

Anatomy

Anatomical localization of the pelvic fascia neural network around the prostate on the cadavers

ZHU Zai-sheng^1* SHI Hong-qi²ZHOU Peng-fei¹XU Li-zhen¹ ZHU Yi-yi³ CHEN Jia-jun³

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Abstract

Objective To investigate the exact localization of neural pathway and the frequency of nerve fibers,which are located in the pelvic facial layers in the prostate and periprostatic regions. Methods Six cadavers with normal pelvic structures were used in this trial. Ten tissue samples, each 1 cm ×1 cm in size, were obtained from each cadaver and zone division separately. The locations of these samples were as follows. Prostate tip (at the junction with the urethra of the membrane): zone 1 from 1 o’clock (apical region), zone 2 from 11 o’clock (apical region). Middle part of the prostate: zone 3 from 2 o’clock(lift far pelvic lateral), zone 4 from 10 o’clock (right far pelvic lateral), zone 5 from 4 o’clock, zone 6 from 8 o’clock, zone 7 from 5 o’clock, zone 8 from 7 o’clock. Base of the prostate (bladder neck junction): zone 9 from 6 o’clock (located on the posterior side of the prostate urethra), 12 o’clock in the 10th zone (located on the ventral side of the prostate).Nerve distribution, frequency and diameters of these 10 zones were compared to each other. Results Sixty specimens were obtained from 6 cadavers. Mean number of nerve fibers was 13.4 ± 13.3. In the 10th zone (prostate basal ventral 12 o’clock), the number of nerves was less distributed (average 5.3 bundles), and there was no statistical significance between the zone 10 and the 6th zone (P>0.05), and the other 8 regions were statistically significant (P<0.05).The average diameter of the nerve fibers was (90.4 ± 61.8)μm, zone 1 of the prostate tip (1 o’clock, average 119.2 μm) and zone 3 of the middle (2 o’clock, average 101.3 μm) nerve fibers are thicker. Zone 1 and 4 at left side of the pelvis (10 o’clock, average 77.7 μm), zone 9 (6 o’clock, average 81.1 μm), and the 10 area at ventral base of the prostate(12 o’clock, average 79.4 μm) (P<0.04, separately) were statistically significant. There was also a statistical difference between the 4 zones (average 77.7 μm) and the contralateral 2 o’clock 3 zones (average 101.3 μm) (P<0.05); Balanced distribution in other regions (P>0.05). Conclusion The distribution of nerve network in the pelvic fascia around the prostate: the number of nerve fibers in the ventral 12 o’clock region of the prostate is small, and the other regions are evenly distributed; The diameter of the nerve fibers is thicker toward the apex in the ventral region of the tip and the left and right are asymmetrically distributed. The pelvic fascia is a key anatomical landmark for the preservation of the nerve during radical prostatectomy.

Key words

Pelvic plexus / Prostate / Zone division / Pathological anatomy / Human

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ZHU Zai-sheng SHI Hong-qi ZHOU Peng-fei XU Li-zhen ZHU Yi-yi CHEN Jia-jun. Anatomical localization of the pelvic fascia neural network around the prostate on the cadavers[J]. Acta Anatomica Sinica. 2020, 51(5): 778-783 https://doi.org/10.16098/j.issn.0529-1356.2020.05.023

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