Following conventional techniques of nerve sparing, the erectile response to nerve stimulation was unaffected. In contrast, the use of energy sources in proximity to the NVB during nerve preservation was associated with a substantial decrease in erectile response both acutely (74%to 91%decrease compared to controls) and after 2 weeks (93%to 96%decrease).
In the chronic canine model, use of hemostatic energy sources in proximity to the prostate during dissection of the neurovascular bundle is associated with a significantly decreased erectile response to cavernous nerve stimulation.
Purchase PDF (539 K) | Anatomical and Electrophysiological Assessment of the C... The Journal of Urology |
  Anatomical and Electrophysiological Assessment of the Canine Periprostatic Neurovascular Anatomy: Perspectives as a Nerve Sparing Radical Prostatectomy ModelThe Journal of Urology, Volume 179, Issue 5, May 2008, Pages 2025-2029 Troy Richard John Gianduzzo, Jose R. Colombo, Ehab El-Gabry, Georges-Pascal Haber, Inderbir S. Gill Abstract PurposeAlthough the dog is often used as a radical prostatectomy model, precise descriptions of canine prostate and neurovascular bundle anatomy are lacking. We describe canine prostate and neurovascular bundle anatomical and electrophysiological characteristics.Materials and MethodsThe canine prostate and pelvic neurovascular structures were dissected in 6 canine cadavers and 12 anesthetized dogs. Pelvic plexus branches were stimulated using a CaverMap® probe and peak intracavernous pressure responses were recorded as a percent of mean arterial pressure. ResultsThe canine pelvic plexus lies 5 to 10 mm lateral to the prostate. It is supplied by the hypogastric nerve cranially and the pelvic nerve laterally. The neurovascular bundles course distal from the pelvic plexus along the posterolateral aspect of the prostate, including a dominant cavernous nerve along its lateral aspect. CaverMap stimulation of the efferent branches of the pelvic plexus confirmed their roles in tumescence. Histology revealed extensive neurovascular tissue along the posterolateral aspect of the prostate beneath the periprostatic fascia. Notable differences to human anatomy were the absence of seminal vesicles, the lateral positions of the pelvic plexus, the dominant cavernous nerve and the circumferential urethral distribution of the cavernous nerves. ConclusionsCanine neurovascular anatomy resembles that of humans and it is a suitable model in which to assess prostatectomy related erectile dysfunction. However, there are key differences in neurovascular relationships that must be considered when the canine prostate is used as a radical prostatectomy model. Purchase PDF (1173 K) |
| REAL The Journal of Urology |
| REAL The Journal of Urology, Volume 172, Issue 1, July 2004, Pages 112-118 OSAMU UKIMURA, INDERBIR S. GILL, MIHIR M. DESAI, ANDREW P. STEINBERG, METE KILCILER, CHRISTOPHER S. NG, SIDNEY C. ABREU, MASSIMILIANO SPALIVIERO, ANUP P. RAMANI, JIHAD H. KAOUK, AKIHIRO KAWAUCHI, TSUNEHARU MIKI Abstract ABSTRACTPurpose:We describe the technical aspects of real-time transrectal ultrasound (TRUS) monitoring and guidance during laparoscopic radical prostatectomy (LRP). Furthermore, we describe the TRUS visualized anatomy of periprostatic structures during LRP. |
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doi:10.1016/j.urology.2007.11.084 
Optical Coherence Tomography of Cavernous Nerves: A Step Toward Real-Time Intraoperative Imaging During Nerve-Sparing Radical Prostatectomy
