Abstract
An overview of the gross and laparoscopic anatomy of the lower urinary tract should summarize both long-standing anatomic knowledge and current scientific findings. In few fields has the anatomic understanding grown as much as urology, especially concerning anatomy of the lower urinary tract. Whereas the gross anatomy is already well known, now research is increasingly contributing to our understanding of the microscopic level. This concerns especially the detailed anatomy and topography of the sphincter mechanism of the urinary bladder, the routing and function of the neural structures in the pelvis and, for example, the anatomic structure of the pelvic floor. The transmission of these new findings in combination with traditional anatomic knowledge into urological practice, including the growing field of laparoscopic surgery, is essential to maintain and improve the success of treatments for our patients. The following chapter gives a clear, detailed and informative summary of the anatomy of the lower urinary tract, especially considering of laparoscopic and endoscopic surgery.
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References
Toellner R. [Illustrated history of medicine]. special ed., vol. III. Salzburg: Andreas & Andreas; 1986. p. 3591.
Benninghoff and Drenckhahn. [Anatomy]. 16th ed. München: Urban & Fischer Verlag; 2003.
Prentiss RJ, et al. Surgical repair of undescended testicle. Calif Med. 1962;96:401–5.
Netter FH. [Atlas of human anatomy]. 1st ed. Stuttgart: Thieme; 1997.
Otcenasek M, et al. Endopelvic fascia in women: shape and relation to parietal pelvic structures. Obstet Gynecol. 2008;111(3):622–30.
Bordoni B, Leslie SW. Anatomy, abdomen and pelvis, pelvic floor. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2018.
Stolzenburg JU, et al. Intrafascial nerve-sparing endoscopic extraperitoneal radical prostatectomy. Eur Urol. 2008;53(5):931–40.
Wimpissinger TF, et al. Surgical anatomy of the puboprostatic complex with special reference to radical perineal prostatectomy. BJU Int. 2003;92(7):681–4.
Young HH. The radical cure of cancer of the prostate. Surg Gynecol Obstet. 1937;64:472–84.
Stolzenburg JU, et al. Anatomical landmarks of radical prostatecomy. Eur Urol. 2007;51(3):629–39.
van Ophoven A, Roth S. The anatomy and embryological origins of the fascia of Denonvilliers: a medico-historical debate. J Urol. 1997;157(1):3–9.
Shapiro E, et al. Morphometric analysis of pediatric and nonhyperplastic prostate glands: evidence that BPH is not a unique stromal process. Prostate. 1997;33(3):177–82.
Zhai LD, et al. The male rectourethralis and deep transverse perineal muscles and their relationship to adjacent structures examined with successive slices of celloidin-embedded pelvic viscera. Eur Urol. 2011;59(3):415–21.
Muraoka K, et al. Site-dependent and interindividual variations in Denonvilliers fascia: a histological study using donated elderly male cadavers. BMC Urol. 2015;15:42.
Kraima AC, et al. Whole mount microscopic sections reveal that Denonvilliers’ fascia is one entity and adherent to the mesorectal fascia; implications for the anterior plane in total mesorectal excision? Eur J Surg Oncol. 2015;41(6):738–45.
Walz J, et al. A critical analysis of the current knowledge of surgical anatomy related to optimization of cancer control and preservation of continence and erection in candidates for radical prostatectomy. Eur Urol. 2010;57(2):179–92.
Fritsch H et al. Clinical anatomy of the pelvic floor. Adv Anat Embryol Cell Biol. 2004;175:III–IX, 1–64.
Nakajima F, et al. Macroscopic and histotopographic study of the deep transverse perineal muscle (musculus transversus perinei profundus) in elderly Japanese. Ann Anat. 2007;189(1):65–74.
Oelrich TM. The urethral sphincter muscle in the male. Am J Anat. 1980;158(2):229–46.
Oelrich TM. The striated urogenital sphincter muscle in the female. Anat Rec. 1983;205(2):223–32.
Shafik A, et al. A novel concept for the surgical anatomy of the perineal body. Dis Colon Rectum. 2007;50(12):2120–5.
Stein TA, DeLancey JO. Structure of the perineal membrane in females: gross and microscopic anatomy. Obstet Gynecol. 2008;111(3):686–93.
Wallner C, et al. The anatomical components of urinary continence. Eur Urol. 2009;55(4):932–43.
Kureel SN, Gupta A, Gupta RK. Surgical anatomy of urogenital diaphragm and course of its vessels in exstrophy-epispadias. Urology. 2011;78(1):159–63.
Wu Y, et al. Architecture of structures in the urogenital triangle of young adult males; comparison with females. J Anat. 2018;233(4):447–59.
Xu Z et al. Denonvilliers’ fascia in men: a sheet plastination and confocal microscopy study of the prerectal space and the presence of an optimal anterior plane when mobilizing the rectum for cancer. Color Dis. 2018;20(3):236–242.
Ghoneim MA, Abol-Enein H. Lymphadenectomy with cystectomy: is it necessary and what is its extent? Eur Urol. 2004;46(4):457–61.
Schilling D, et al. Cystectomy in women. BJU Int. 2008;102(9 Pt B):1289–95.
Baader B et al. [Autonomic innervation of the female pelvis. Anatomic basis]. Urologe A. 2004;43(2):133–40.
Baader B, Herrmann M. Topography of the pelvic autonomic nervous system and its potential impact on surgical intervention in the pelvis. Clin Anat. 2003;16(2):119–30.
Di Gangi Herms AM, et al. Functional imaging of stress urinary incontinence. NeuroImage. 2006;29(1):267–75.
Spence KT, Forro SD. Anatomy, bony pelvis and lower limb, nerves. In: StatPearls. Treasure Island: StatPearls Publishing; 2018.
McNeal JE. Regional morphology and pathology of the prostate. Am J Clin Pathol. 1968;49(3):347–57.
Corvin S, et al. Laparoscopic sentinel lymph node dissection—a novel technique for the staging of prostate cancer. Eur Urol. 2006;49(2):280–5.
Eichelberg C et al. Nerve distribution along the prostatic capsule. Eur Urol. 2007;51(1):105–10; discussion 110–1.
Ganzer R, et al. Topographical anatomy of periprostatic and capsular nerves: quantification and computerised planimetry. Eur Urol. 2008;54(2):353–61.
Heidenreich A, Ohlmann CH, Polyakov S. Anatomical extent of pelvic lymphadenectomy in patients undergoing radical prostatectomy. Eur Urol. 2007;52(1):29–37.
Kaiho Y, et al. Nerves at the ventral prostatic capsule contribute to erectile function: initial electrophysiological assessment in humans. Eur Urol. 2009;55(1):148–54.
Karam I, et al. The precise location and nature of the nerves to the male human urethra: histological and immunohistochemical studies with three-dimensional reconstruction. Eur Urol. 2005;48(5):858–64.
Mulhall JP, Secin FP, Guillonneau B. Artery sparing radical prostatectomy—myth or reality? J Urol. 2008;179(3):827–31.
Secin FP, et al. Anatomy and preservation of accessory pudendal arteries in laparoscopic radical prostatectomy. Eur Urol. 2007;51(5):1229–35.
Sievert KD, et al. The Periprostatic autonomic nerves-bundle or layer? Eur Urol. 2008;54:1109–17.
Villers A, Steg A, Boccon-Gibod L. Anatomy of the prostate: review of the different models. Eur Urol. 1991;20(4):261–8.
Woods ME, Ouwenga M, Quek ML. The role of pelvic lymphadenectomy in the management of prostate and bladder cancer. Sci World J. 2007;7:789–99.
Gil-Vernet JM. Prostate cancer: anatomical and surgical considerations. Br J Urol. 1996;78(2):161–8.
Dorschner W, et al. The dispute about the external sphincter and the urogenital diaphragm. J Urol. 1999;162(6):1942–5.
Yucel S, Baskin LS. An anatomical description of the male and female urethral sphincter complex. J Urol. 2004;171(5):1890–7.
Reeves F, et al. High-resolution map of somatic periprostatic nerves. Urology. 2016;97:160–5.
Sievert KD, et al. Extended periprostatic nerve distributions on the prostate surface confirmed using diffusion tensor imaging. BJU Int. 2019;123(6):995–1004.
Costello AJ, et al. Immunohistochemical study of the cavernous nerves in the periprostatic region. BJU Int. 2011;107(8):1210–5.
Colleselli K, et al. The female urethral sphincter: a morphological and topographical study. J Urol. 1998;160(1):49–54.
Strasser H, et al. Anatomic and functional studies of the male and female urethral sphincter. World J Urol. 2000;18(5):324–9.
Koraitim MM. The male urethral sphincter complex revisited: an anatomical concept and its physiological correlate. J Urol. 2008;179(5):1683–9.
Sam P, LaGrange CA. Anatomy, abdomen and pelvis, sphincter urethrae. In: StatPearls. Treasure Island: StatPearls Publishing; 2018.
Amend B et al. Surgical anatomy of the urinary bladder. In: John H, Wiklund P, editors. Robotic urology. Cham: Springer Nature; 2018.
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Amend, B., Stenzl, A. (2020). Gross and Laparoscopic Anatomy of the Lower Tract and Pelvis. In: Chapple, C., Steers, W., Evans, C. (eds) Urologic Principles and Practice. Springer Specialist Surgery Series. Springer, Cham. https://doi.org/10.1007/978-3-030-28599-9_2
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DOI: https://doi.org/10.1007/978-3-030-28599-9_2
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