盆腔神经血管束的解剖及与下尿路手术的关系

Anatomy of the neurovascular bundle and its relation with lower urinary tract operation

目的 认识盆腔神经血管束(NVB)与周围组织器官的关系。方法 对4个成人男性盆腔器官标本作NVB大体解剖或组织切片,观察NVB与周围组织器官的关系。结果 由盆丛发出的海绵体神经在前列腺基底部与前列腺血管形成NVB,NVB的密度沿前列腺下行时逐渐变稀,于尿道膜部外侧和后外侧穿过尿生殖膈。NVB在前列腺包膜外、盆筋膜内,NVB在前列腺基底部、尖部水平与前列腺包膜距离约1.5mm和3mm。结论 明确NVB与周围组织器官的关系,为下尿路手术中避免损伤海绵体神经,减少医源性ED有重要意义。

Objective To delineate the exact relationships of the neurovascular bundle (NVB) to its adjacent organs for preventing from iatrogenic impotence during lower urinary tract surgery. Methods Deta iled anatomical dissection was performed on 4 male human cadavers and the exact relationship of NVB to its adjacent organs was observed. Results The cavemous nerves arise form the pelvis plexus are associated with vessels of the prostate along the base of prostate coalescing an organized bundle (NVB). The nerve density of NVB consistently decreases as the bundles course along the prostate. The prostatic capsule and NVB are separated by 1.5 to 3 mm. Conclusions It is essential to identify the exact relationships of NVB to its adjacent organs to avoid injury to the cavernous nerves during lower urinary tract surgery and prevent from iatrogenic ED.