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Extended periprostatic nerve distributions on the prostate surface confirmed using diffusion tensor imaging.

Karl-Dietrich Sievert1,2,3,4, Jörg Hennenlotter1, Thomas Dillenburg1

  • 1Department of Urology, Eberhard-Karls University Tuebingen, Tuebingen, Germany.

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|August 10, 2018
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Summary
This summary is machine-generated.

This study mapped prostate nerves using microscopy and diffusion tensor imaging (DTI). DTI confirmed nerve distributions, aiding in nerve-sparing radical prostatectomy planning.

Keywords:
cavernous nerveserectile functionneurovascular bundleperiprostatic nerve tissueradical prostatectomyurinary continence

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Area of Science:

  • Urology
  • Neuroanatomy
  • Medical Imaging

Background:

  • Periprostatic nerve distribution is crucial for preserving function after radical prostatectomy (RP).
  • Microscopic characterization of nerve qualities and their anatomical distribution is essential for surgical planning.

Purpose of the Study:

  • To anatomically characterize periprostatic nerve distributions using prostatectomy specimens.
  • To visualize these nerve distributions using diffusion tensor imaging (DTI).

Main Methods:

  • Microscopic analysis of 19 prostatectomy specimens stained for cholinergic, adrenergic, and sensory nerves.
  • Quantification and classification of extracapsular nerves by prostate surface sector and diameter.
  • Investigation of nerve concordance using 3-Tesla MRI-DTI in five male volunteers.

Main Results:

  • Cholinergic, adrenergic, and sensory nerves exhibited distinct distribution patterns from the base to the apex of the prostate.
  • DTI successfully confirmed the histological findings of nerve distribution.
  • While different nerve qualities could not be distinguished by DTI, overall nerve structures were visualized.

Conclusions:

  • Nerve fibre distributions vary, providing morphological evidence important for functional preservation after RP.
  • DTI is a valuable tool for correlating nerve location with tumors, potentially improving preoperative planning and treatment.
  • This study represents the first use of DTI to confirm histological findings in nerve-sparing RP.