海绵体神经在前列腺尖部及远端的行程与分布  

Cavernous nerves innervation from prostate apex to distal penis

作　　者：李俊[1] 黄健[1] 虞湘才[2] 黄海[1] 

机构地区：[1]中山大学附属第二医院泌尿外科,广州510120 [2]广东省佛山市顺德区第一人民医院泌尿外科

出　　处：《中华泌尿外科杂志》2009年第8期556-558,共3页Chinese Journal of Urology

基　　金：国家卫生公益性行业科研专项资金资助项目（200802015）;卫生部临床重点项目（2007年）;广州市科技局项目重点基金资助项目（200522-E0121）

摘　　要：目的观察海绵体神经在前列腺尖部及其远端的行程和分布，探讨海绵体神经与周围组织的关系。方法3具成年男性尸体尿道和阴茎标本，自前列腺尖部至阴茎头连续切片行HE染色和神经纤维嗜银染色，观察海绵体神经在前列腺尖部及其远端尿道膜部阴茎的行程与分布。结果海绵体神经纤维束行于前列腺尖部和尿道膜部约3点到9点处，距离尿道腔约3～5mm，向远端进入阴茎海绵体近段。自尿道膜部向前走行与海绵体静脉丛并行进入海绵体中隔。结论海绵体神经在前列腺尖部以及阴茎近段与尿道及海绵体静脉关系密切，该部位尿道和海绵体静脉相关手术容易损伤海绵体神经。Objective To investigate the cavernous nerves innervation from prostate apex to glans penis and the relation between cavernous nerves and surrounding tissues and organs. Methods The urethra and penises of three formalin preserved adult cadavers were removed from prostate apex to glans penis. The sections underwent hematoxylin-eosin staining and Bielschowsky nerve staining. The course and distribution of cavernous nerves and relationship between the cavernous nerves and surrounding tissues and organs was observed microscopically and photographed from prostate apex to glans penis. Results From serial sections we found when nerve fibres run along prostate apex, while surrounding the lateral and dorsal aspects of prostate apex and urethra, from 3 o＇clock to 9 o＇ clock. Most fibres went through smooth muscle and some of them went through the periphery striated muscle and urogenital diaphragm. The distance to urethra lumen was only 3--5 mm. After the nerve fibres went distally and anteriorly, they accompanied closely with cavernous vein plexus and then went into corpora cavernosa. At the distal end of corpora cavernosa, there were ＂windows＂ through which the neurovascular bundles communicated between corpora cavernosa and glans penis just like doors to glans penis. Conclusions When nerve fibres run from prostate apex to urogenital diaphragm, along dorsal lateral aspect of prostate and urethra, there are only 3--5 mm to the urethra lumen, so it is very easy to be injured in traumas or operations. In the urethral bulb fragment, the nerves run anteriorly and laterally, out of the periphary muscle, so the cavernous nerves will not be injured when dissect urethra bulb from surrounding muscles. Dissect glans penis from distal end of penis in operation would be avoided in order to protect the cavernous nerves between corpora cavernosa and glans penis.

关 键 词：海绵体神经 前列腺 尿生殖膈 解剖学 

分 类 号：R686[医药卫生—骨科学]