INTRODUCTION: Despite the vast literature on pelvic fascia, there is confusion over the periprostatic structures and their nomenclature, including their orientation, the neurovascular bundles and the existence of the prostatic 'capsule'. In this review, we seek to clarify some of these issues. MATERIALS AND METHODS: Review of published medical literature relating to the anatomy of the pelvic fascia including a Pubmed search using the terms - pelvic fascia, Denonvilliers' fascia, prostate capsule, neurovascular bundle of Walsh, puboprostatic ligament and the detrusor apron. CONCLUSIONS: The findings of the study were as follows: 1. The 'capsule' of the prostate does not exist. Rather, the fibromuscular band surrounding the prostate forms an integral part of the gland. 2. The prostate is surrounded by fascial structures - anteriorly/anterolaterally by the prostatic fascia and posteriorly by the Denonvilliers' fascia. Laterally, the prostatic fascia merges with the endopelvic fascia. 3. The posterior longitudinal fascia of the detrusor comprises a 'posterior layer' of the detrusor apron, extending from the bladder neck to the prostate base. 4. The neurovascular structures tend to be located posterolaterally, but may not always form a bundle. A significant proportion of fibres may lie away from the main nerve structures, along the lateral/posterior aspects of the prostate.
INTRODUCTION: Despite the vast literature on pelvic fascia, there is confusion over the periprostatic structures and their nomenclature, including their orientation, the neurovascular bundles and the existence of the prostatic 'capsule'. In this review, we seek to clarify some of these issues. MATERIALS AND METHODS: Review of published medical literature relating to the anatomy of the pelvic fascia including a Pubmed search using the terms - pelvic fascia, Denonvilliers' fascia, prostate capsule, neurovascular bundle of Walsh, puboprostatic ligament and the detrusor apron. CONCLUSIONS: The findings of the study were as follows: 1. The 'capsule' of the prostate does not exist. Rather, the fibromuscular band surrounding the prostate forms an integral part of the gland. 2. The prostate is surrounded by fascial structures - anteriorly/anterolaterally by the prostatic fascia and posteriorly by the Denonvilliers' fascia. Laterally, the prostatic fascia merges with the endopelvic fascia. 3. The posterior longitudinal fascia of the detrusor comprises a 'posterior layer' of the detrusor apron, extending from the bladder neck to the prostate base. 4. The neurovascular structures tend to be located posterolaterally, but may not always form a bundle. A significant proportion of fibres may lie away from the main nerve structures, along the lateral/posterior aspects of the prostate.
Authors: Fernando P Secin; Nicholas Karanikolas; Anuradha Gopalan; Fernando J Bianco; Bobby Shayegan; Karim Touijer; Semra Olgac; Robert P Myers; Guido Dalbagni; Bertrand Guillonneau Journal: J Urol Date: 2007-02 Impact factor: 7.450
Authors: S Di Lollo; I Menchi; E Brizzi; P Pacini; A Papucci; E Sgambati; M Carini; M Gulisano Journal: Surg Radiol Anat Date: 1997 Impact factor: 1.246
Authors: Ji Hyun Kim; Yusuke Kinugasa; Si Eun Hwang; Gen Murakami; Jose Francisco Rodríguez-Vázquez; Baik Hwan Cho Journal: Surg Radiol Anat Date: 2014-07-10 Impact factor: 1.246
Authors: María García-Gausí; Juan García-Armengol; Gianluca Pellino; Claudia Mulas; José V Roig; Alvaro García-Granero; David Moro; Alfonso Valverde Journal: Updates Surg Date: 2022-03-14
Authors: Benedikt Hoeh; Mike Wenzel; Lukas Hohenhorst; Jens Köllermann; Markus Graefen; Alexander Haese; Derya Tilki; Jochen Walz; Marina Kosiba; Andreas Becker; Severine Banek; Luis A Kluth; Philipp Mandel; Pierre I Karakiewicz; Felix K H Chun; Felix Preisser Journal: Front Surg Date: 2022-02-22