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Anatomy of the Prostatic Urethra and Sphincters: Normal and Pathological Variants
Marco Finati1, Alessandro Uleri2, Melissa R Kaufman3
1Department of Urology, La Croix du Sud Hospital, Quint-Fonsegrives, France; Department of Urology and Renal Transplantation, Policlinico Riuniti University Hospital, Foggia, Italy.
European Urology Focus
|June 20, 2026
Summary
Benign prostatic hyperplasia (BPH) involves overlooked prostatic urethra and sphincter anatomy. Understanding these structures improves symptom prediction and surgical outcomes for BPH patients.
Area of Science:
- Urology
- Anatomy
- Medical Imaging
Background:
- The prostatic urethra and distal sphincteric complex are critical yet often overlooked in benign prostatic hyperplasia (BPH) evaluations.
- Anatomical variations in the prostatic urethra's length, curvature, and angulation significantly impact hydrodynamics and BPH symptoms.
- The periverumontanal region's role in semen accumulation and antegrade flow is increasingly recognized.
Purpose of the Study:
- To highlight the importance of the prostatic urethra and distal sphincteric complex in BPH.
- To explore how anatomical variations in these regions influence BPH symptoms and treatment.
- To correlate anatomical findings with ejaculatory dysfunction and atypical lower urinary tract symptoms.
Main Methods:
- Review of emerging anatomical studies.
- Analysis of real-time imaging data.
- Correlation of anatomical features with clinical presentations and surgical considerations.
Main Results:
- Prostatic urethra anatomy dynamically affects hydrodynamics and symptoms beyond prostate volume.
- The periverumontanal region acts as an antichamber influencing ejaculatory mechanics.
- Distal sphincter anatomy may extend beyond conventional landmarks, impacting continence and sexual function.
Conclusions:
- Anatomical considerations of the prostatic urethra and sphincter are vital for BPH management.
- Understanding these overlooked structures can explain atypical symptoms like pelvic discomfort or dysorgasmia.
- Incorporating detailed anatomical assessment may refine surgical planning and improve patient outcomes in BPH.
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