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Nerve quantification and computerized planimetry to evaluate periprostatic nerve distribution-does size matter?

Roman Ganzer1, Andreas Blana, Jens-Uwe Stolzenburg

  • 1Department of Urology, Krankenhaus St. Josef, University of Regensburg, Germany. roman.ganzer@gmx.de

Urology
|April 21, 2009
PubMed
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Prostate size does not impact periprostatic nerve distribution (PND). Nerve density varies by region, with higher percentages in ventrolateral and dorsal areas, regardless of prostate volume. These findings are crucial for nerve-sparing prostatectomy planning.

Area of Science:

  • Urology
  • Surgical Anatomy
  • Nerve Physiology

Background:

  • Periprostatic nerve distribution (PND) exhibits variability, potentially impacting surgical outcomes.
  • Factors influencing this anatomical variability, particularly prostate size, remain under-investigated.

Purpose of the Study:

  • To determine if prostate size influences the distribution of periprostatic autonomic nerve fibers.
  • To analyze nerve surface area and density across different prostatic regions in relation to prostate volume.

Main Methods:

  • Analysis of 45 whole-mount prostate sections stained for autonomic nerve fibers.
  • Quantification of nerve surface area using computerized planimetry (ImageJ software) in defined regions.
  • Grouping prostates into <30 cm³ and ≥30 cm³ for comparative analysis.

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Main Results:

  • No significant difference in PND was observed between prostates smaller than 30 cm³ and those larger than or equal to 30 cm³.
  • The ventrolateral and dorsal regions consistently showed higher percentages of nerve surface area across all specimens.
  • While the number of nerves remained consistent, the total nerve surface area significantly decreased from the base to the apex of the prostate.

Conclusions:

  • Prostate size, as defined in this study, does not appear to affect periprostatic nerve distribution.
  • Understanding regional nerve variations is essential for optimizing nerve-sparing prostatectomy techniques.
  • These anatomical insights can guide surgical planning to preserve nerve function during radical prostatectomy.