Mapping of functional erectogenic nerves on the rat prostate

Area of Science:

• Urology
• Neuroscience
• Surgical Anatomy

Background:

• Preserving erectogenic nerves during radical prostatectomy (RP) is challenging due to complex anatomy and patient variations.
• Erection involves specific cavernous nerves (CNs) that phosphorylate neuronal nitric oxide synthase (nNOS) at Ser-1412 in response to sexual stimuli.

Purpose of the Study:

• To map the distribution and quantity of functional erection-relevant ([P-nNOS]-containing) nerves in the periprostatic area.
• To differentiate these functional nerves within the overall CNs distribution.
• To investigate potential functional communication between contralateral CNs.

Main Methods:

• Electrical stimulation of CNs in rats to induce penile erection and nNOS phosphorylation at Ser-1412.
• Whole-mount double-staining of prostate tissues using TuJ1 (pan-axonal marker) and P-nNOS or total nNOS antibodies.
• Modified optical clearing and microscopic examination for nerve visualization and quantification.

Main Results:

• A detailed map of P-nNOS-containing nerves, crucial for erection, was generated in the rat periprostatic area.
• Functionally erectogenic nerves constitute only 17.5% of all periprostatic nerves and 28.4% of total nNOS-containing nerves.
• No functional innervation was found between contralateral CNs.

Conclusions:

• A distinct subset of periprostatic nerve fibers, identified by P-nNOS (Ser-1412) expression, represents functional erectogenic nerves.
• This foundational research is expected to enhance nerve-sparing RP techniques and improve post-operative sexual function in humans.
• Further studies with larger sample sizes are warranted to validate these findings.