Neurovascular Supply of the Prostate and Corpora Cavernosa Effects on Erectile Dysfunction and Urinary Incontinence After Radical Prostatectomy

Abstract

Radical prostatectomy is typically the main treatment option for patients with prostate cancer. Despite advances in surgical techniques and neurovascular preservation, the prevalence of erectile dysfunction and urinary incontinence in patients post-radical prostatectomy remains varied. Consequently, it is essential to identify and understand the distribution and pathways of periprostatic neurovascular structures to limit complications following radical prostatectomy. This review provides an overview of the literature investigating the neurovascular supply of the prostate and corpora cavernosa, particularly in relation to erectile dysfunction and urine incontinence. We screened publications listed on the PubMed database, incorporating all articles published in English that investigated humans. A wide range of uncertainty and complexity was revealed concerning the blood supply and innervation of the prostate and corpora cavernosa, with regard to their origin, course, branches, and region of insertion. Given that the preservation of neurovascular structures is beneficial for improving outcomes following radical prostatectomy, the lack of a definitive consensus of their anatomy makes it difficult to propose a simple approach to improve surgical procedures. Our findings suggest that further work exploring this important aspect of clinically relevant human anatomy is required.