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A histological study of Denonvilliers' fascia and its relationship to the neurovascular bundle
J Kourambas1, D G Angus, P Hosking
1Austin and Repatriation Medical Centre, Victoria, Australia.
Objective:
To evaluate the anatomical relationship between the nerves and fasciae at the site of dissection in a radical retropubic prostatectomy.
Materials And Methods:
Eight adult male (autopsy) en bloc specimens of bladder and rectum were examined histologically after staining with either haematoxylin and eosin or S-100 protein (as a specific nerve stain).
Results:
All specimens showed Denovilliers' fascia to have no clearly defined layers and no definable lateral edge. No distinct neurovascular bundle was seen but nerves were scattered throughout the fasciae, including medially towards the midline.
Conclusion:
In radical retropubic prostatectomy, a piece of Denonvilliers' fascia is taken with the specimen, thus removing these nerves. The loss of these nerve fibres may explain the significant rate of erectile dysfunction after 'nerve-sparing' surgery.