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[Innervation of Denonvilliers' recto-vesical fascia. Anatomical study]
O Dumonceau1, V Delmas, M Toublanc
1Service d'Urologie, Hôpital Bichat, Paris, France.
Objective:
Dissection of Denonvilliers' rectovesical fascia allows easy cleavage of the prostatorectal and prostatovesical spaces. Its lateral limit in the "neurovascular pedicles" justifies its resection during radical prostatectomy. The objective of this study was to define the course and to observe the structure of nerves crossing the rectovesical fascia, as the sheaths of these nerves may be invaded by prostatic adenocarcinoma tumour cells.
Material And Methods:
After dissection of a fresh cadavre to define the relations of this fascia with the pedicles, rectovesical fascia biopsies were taken during radical prostatectomies. Transverse sections were performed and examined histologically.
Results:
Certain nerves, derived from the neurovascular pedicle of the inferior hypogastric plexus, cross the rectovesical fascia to innervate the prostate.
Conclusion:
This confirms the importance of complete resection of the rectovesical fascia during radical prostatectomy for cancer, not only for surgical reasons, but also to ensure oncologically satisfactory surgery, i.e. with healthy resection margins.