Carcinoma of the prostate: value of transrectal sonography in detecting extension into the neurovascular bundle

AJR. American Journal of Roentgenology
U HamperJ I Epstein

Abstract

Detection of involvement of the neurovascular bundles (NVB) by tumor is important in deciding whether sexual function can be preserved in patients undergoing radical prostatectomy for prostatic cancer. The nerve branches innervating the corpora cavernosa have a rather constant association with the capsular arteries and veins of the prostate, forming the periprostatic neurovascular bundle, which can be identified intraoperatively and spared during radical surgery, thus preserving potency. We examined 160 patients with biopsy-proved clinical stage A or B adenocarcinoma with transrectal sonography before radical prostatectomy to determine how useful the procedure is for predicting tumor extension into the NVB. Correlation with pathologic serial sections was obtained in each patient. The sonograms depicted the NVB on both sides in 77 patients (50%), on the right side only in 13 (8%), and on the left side only in 36 patients (23%). In 29 patients (19%) neither neurovascular bundle could be identified on the sonograms. Ninety-one tumors in this series showed evidence of extraglandular spread pathologically, which was posterolateral or into the NVB in 70 tumors involving 82 hemispheres. Using transrectal sonography, we correctly ident...Continue Reading

Citations

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