| Budget Amount *help |
¥3,790,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥390,000)
Fiscal Year 2007: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
Fiscal Year 2006: ¥2,100,000 (Direct Cost: ¥2,100,000)
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| Research Abstract |
1. Anatomic research
We clarified the topographical relationship between the urethral rhabdosphincter and the rectourethralis muscle. Using 15 male cadavers, the rectourethralis muscle was defined and located at the interface between the levator ani muscle and rectum. The fibromuscular node known as the perineal body was not identified histologically. The urethral rhabdosphincter did not insert into the connective tissues or tendinous raphe between the perineal muscles, but to the rectourethralis muscle composed of the smooth muscle fibers. Abundant nerves passed between the rectourethralis muscle and levator ani, or through the rectourethralis muscle.
2. Electrophysiologic research
Eelectrical stimulation was performed in 29 laparoscopic radical prostatectomies, and change in intracavernous pressure was measured. Before removal of the prostate, nerve stimulation was performed at the base and middle of neurovascular bundle (point A and point B, respectively), the rectal wall about 1 cm posterolateral to the neurovascular bundle (point C), and the lateral aspect of the prostate (point D) to map the cavernous nerves. The mean ± SD increases in intracavernous pressure were 10.9 ± 7.9 cmH2O, 11.9 ± 8.7 cmH2O, 9.7 ± 7.5 cmH2O, and 6.9 ± 7.1 cmH2O, at point A, point B, point C, and point D, respectively. This showed the cavernous nerve fibers distributed not only at the neurovascular bundle, but also at the lateral aspect of the prostate and the rectal wall posterolateral to the neurovascular bundle. We determined the distribution of the cavernous nerve fibers case by case, and divided the distribution of cavernous nerve fibers into four groups. Type 1: bundle type corresponding to the neurovascular bundle, Type 2: bundle type along the rectal wall, Type 3: plate type including the neurovascular bundle and the posterolateral to the neurovascular bundle, and Type 4: plate type including the neurovascular bundle, the postero- and anterolateral the neurovascular bundle.
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