1Department of Urology, Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, China; 2Department of Pathology, Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, China; 3Department of Ultrasound, Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, China; 4Master of Clinical Practice, Zhejiang University School of Medicine, Hangzhou 321000, China
Abstract：Objective To explore the anatomical distribution and basic spatial structure of the microneural network around the prostate.Methods A prospective study was performed on 12 patients who underwent radical bladder and prostatectomy for bladder malignancies from January 2015 to December 2017 in Jinhua Hospital of Zhejiang University. Fresh prostate and bladder full-cut specimens were divided into base, middle and tip according to the natural anatomy. The pathological sections of the three-part organization team were sliced, and the 12 points of the numbered Ⅰ~ⅫI were divided clockwise into the 12 points of the pathological section centered by the pathological slice center. The corresponding areas on the left and right sides of the prostate were merged into the ventral side, Area (Ⅻ+Ⅰ area), anterolateral anterior area (Ⅱ+Ⅺ area), anterior lateral area (Ⅲ+Ⅹ area), posterolateral area (Ⅳ+Ⅸ area), posterior lateral area (Ⅴ+Ⅷ area) and back. There are 6 sectoral areas in the side area (Ⅵ+Ⅶ area). Taking the prostate capsule as the boundary, according to the distance from the prostate capsule 2.0 mm and 4.0 mm, the surrounding tissue of the prostate capsule was divided into three ring-shaped observation areas from the inside to the outside, which were A1 area, A2 and A3 area, respectively. The number of nerve fibers in three anatomical sites, six regions and 18 observation zones were counted, and the distribution characteristics and spatial structure of nerve fibers were observed.Results A total of 168 large-sized sections were obtained from 12 specimens in the whole group, and 108 slices were finally included. Among them, 36 sections were included in the base, middle and tip of the prostate. A total of 17,881 bundles of nerve fibers were observed in the surrounding tissues of the prostate capsule, including a basement nerve fiber of 9 443 (52.81%), a central 6 102 bundle (34.13%), and a tip 2 336 (13.06%). A total of 5 819 bundles (32.54%) of the ventral, ventral anterior and anterolateral nerve fibers of the prostate were significantly lower than the 12 062 (67.46%) of the posterolateral, posterolateral and dorsal sides. The number of nerve fibers in different observation areas outside the prostate capsule was 8 231 in the A1 area, 5 963 in the A3 area, and 3 687 in the A2 area. In the three anatomical sites and six regions, the nerve fibers were mainly distributed in the posterolateral, posterolateral and dorsal sides of the prostate. The number of basal, central and apical nerve fibers was 6 576 (36.8%) and 4 112(23.0%), respectively. 1 374(7.6%) bundles, especially in the posterolateral region, the most distributed nerve fibers; and the ventral, ventral anterior and anterior lateral, respectively, 2 867(16.0%) bundles, 1 990(11.1%) bundles and 962(3.4%) bundles, among which the ventral region had the least distribution of nerve fibers. There were significant differences in the distribution of peripheral nerves of the prostate capsule in different anatomical regions and regions (χ2=552.700, P＜0.01). The three-dimensional spatial distribution of the peripheral nerve network of the prostate envelope: (1) The number of nerve fibers in the posterolateral, posterolateral and dorsal sides was significantly higher than that in the ventral, ventral anterior and anterior lateral. (2) Number of nerve fibers in different observation areas: the base part was A3＞A1＞A2 area, and the number was far from the prostate capsule. The middle part was A1＞A2 ＞A3 area, and the number was near the prostate capsule. The tip was the lower part of the A1＞A3＞A2 area, and the upper part was the A1＞A2＞A3 area.Conclusions Three-dimensional anatomical structure of the peripheral nerve network of the prostate: at the base of the prostate, the number of nerve fibers is the largest, most of which are distributed in the dorsal region of the prostate, away from the outer layer of the prostate capsule; at the tip end, the number of nerve fibers is the least, the nerve fibers turn to the ventral region, the inner layer closest to the prostate capsule; the middle is the gradual transition zone of nerve fibers.
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2019, Vol. 24 
