Controversias en la anatomía quirúrgica prostática. Revisión de la literarura
Controversies in the prostate surgical anatomy. A literature review
I. Juan Gardiner Monzó
, Felipe Herranz Amo**, Ramiro Cabello Benavente*, Maximiliano Bun***, Jesús Gómez Muñoz*, Carmen González Enguita*
,1
Autor para correspondencia
jimonzo@fjd.es
Correspondencia autor: Dr. Juan Ignacio Monzó Gardiner Servicio de Urología. Fundación Jiménez Díaz Avda. Reyes Católicos, 2 - 28040 Madrid, España Tel. 915 504 800
Correspondencia autor: Dr. Juan Ignacio Monzó Gardiner Servicio de Urología. Fundación Jiménez Díaz Avda. Reyes Católicos, 2 - 28040 Madrid, España Tel. 915 504 800
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"apellidos" => "Juan Gardiner Monzó" "email" => array:1 [ 0 => "jimonzo@fjd.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Felipe" "apellidos" => "Herranz Amo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Ramiro" "apellidos" => "Cabello Benavente" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Maximiliano" "apellidos" => "Bun" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">***</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "Jesús" "apellidos" => "Gómez Muñoz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Carmen" "apellidos" => "González Enguita" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Fundación Jiménez Díaz," "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hospital General Universitario Gregorio Marañón, Madrid, España" "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Hospital Alemán, Buenos Aires, Argentina" "etiqueta" => "<span class="elsevierStyleSup">***</span>" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia autor: Dr. Juan Ignacio Monzó Gardiner Servicio de Urología. Fundación Jiménez Díaz Avda. Reyes Católicos, 2 - 28040 Madrid, España Tel. 915 504 800" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Controversies in the prostate surgical anatomy. A literature review" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-10-01" "fechaAceptado" => "2009-01-01" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec88907" "palabras" => array:4 [ 0 => "Nervios cavernosos" 1 => "Prostatectomía" 2 => "Anatomía" 3 => "Fascículo neurovascular" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec88908" "palabras" => array:4 [ 0 => "Cavernosal nerves" 1 => "Prostatectomy" 2 => "Anatomy" 3 => "Neurovascular bundle" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La técnica para la prostatectomía radical ha evolucionado dinámicamente durante los últimos años en base a una mayor experiencia quirúrgica acumulada y descubrimientos anatómicos. Nos parece oportuno revisar y actualizar algunos conceptos anatómicos básicos que nos permita conseguir una uniformidad de criterios y términos al referirnos a esta técnica quirúrgica.</p> <span class="elsevierStyleSectionTitle">Material y Método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Hemos realizado una búsqueda bibliográfica en Medline/PubMed. Palabras clave: cavernosal nerves, prostatectomy, anatomy, neurovascular bundle. Realizamos una lectura detallada de los resúmenes de los artículos obtenidos, seleccionando aquellos que se ajustaban a los diferentes temas fijados para la revisión</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La glándula prostática no posee una cápsula verdadera sino que esta representada por una banda fibromuscular incompleta que es intrínseca a la glándula. La fascia periprostática parece ser una estructura distinta de esta banda fibromuscular. La Fascia de Denonvilliers en una fascia histológicamente compuesta por dos láminas pero quirúrgicamente indistinguibles. Las fibras ubicadas longitudinalmente por debajo del labio posterior del cuello vesical parecen corresponder a la fascia longitudinal posterior que pertenece al músculo detrusor. Los nervios cavernosos se sitúan entre dos hojas de la fascia endopélvica que podríamos denominar fascia periprostática (más interna) y fascia del elevador (más externa). Los nervios cavernosos son eferencias del plexo pélvico y se ubican dentro de un fascículo neurovascular con distribución variable alrededor de la próstata según cada individuo (fascículo único o dispersos por la superficie anterolateral de la próstata). Consideramos conveniente que la comunidad de Urólogos unifique los términos para denominar las fascias pélvicas y evitar superposición de términos.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Radical prostatectomy technique has improved in the last years based on accumulated surgical experience and new anatomical findings. We think it is time to update anatomical concepts to standardized the criteria for mentioning structures related with radical prostatectomy</p> <span class="elsevierStyleSectionTitle">Material and Method</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">With the followings key words: “cavernosal nerves, prostatectomy, anatomy, neurovascular bundle” we search in Medline/PubMed database selecting papers fulfilling the search criteria.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The prostate does not have a true capsule but rather an incomplete fibromuscular band as an intrinsic part of the gland. Periprostatic fascia seems to be a different structure from this fibromuscular band. Histologically Denonvilliers´s fascia is formed by two thin layers that cannot be separated during surgery. The longitudinal smooth muscle fibres located beneath the posterior bladder neck corresponds to the posterior longitudinal fascia of the detrusor muscle. Cavernosal nerves are located between the two layers of the endopelvic fascia, the inner layer could be named periprostatic fascia and the outer, levator ani fascia. Cavernosal nerves merged from the pelvic plexus running within a neurovascular bundle around the prostate that could be found as a singular bundle or spread all around the anterolateral surface of this gland. There are overlapping terms to designate the pelvic fascia, therefore it could be useful for Urologists to standardized them.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:31 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| 2024 Septiembre | 0 | 20 | 20 |
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| 2023 Marzo | 11 | 60 | 71 |
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| 2019 Octubre | 0 | 5 | 5 |
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| 2019 Abril | 0 | 35 | 35 |
| 2019 Marzo | 0 | 5 | 5 |
| 2019 Febrero | 0 | 10 | 10 |
| 2019 Enero | 0 | 1 | 1 |
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| 2018 Octubre | 0 | 17 | 17 |
| 2018 Septiembre | 0 | 3 | 3 |
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| 2018 Febrero | 1 | 5 | 6 |
| 2018 Enero | 2 | 1 | 3 |
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| 2017 Noviembre | 6 | 8 | 14 |
| 2017 Octubre | 7 | 1 | 8 |
| 2017 Septiembre | 13 | 8 | 21 |
| 2017 Agosto | 19 | 6 | 25 |
| 2017 Julio | 20 | 3 | 23 |
| 2017 Junio | 16 | 16 | 32 |
| 2017 Mayo | 3 | 5 | 8 |
| 2017 Abril | 9 | 5 | 14 |
| 2017 Marzo | 33 | 33 | 66 |
| 2017 Febrero | 17 | 1 | 18 |
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| 2016 Noviembre | 32 | 3 | 35 |
| 2016 Octubre | 34 | 11 | 45 |
| 2016 Septiembre | 16 | 7 | 23 |
| 2016 Agosto | 11 | 5 | 16 |
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| 2016 Mayo | 19 | 30 | 49 |
| 2016 Abril | 16 | 19 | 35 |
| 2016 Marzo | 16 | 20 | 36 |
| 2016 Febrero | 18 | 31 | 49 |
| 2016 Enero | 9 | 33 | 42 |
| 2015 Diciembre | 15 | 20 | 35 |
| 2015 Noviembre | 16 | 20 | 36 |
| 2015 Octubre | 19 | 22 | 41 |
| 2015 Septiembre | 12 | 18 | 30 |
| 2015 Agosto | 16 | 8 | 24 |
| 2015 Julio | 10 | 20 | 30 |
| 2015 Junio | 6 | 1 | 7 |
| 2015 Mayo | 5 | 12 | 17 |
| 2015 Abril | 11 | 11 | 22 |
| 2015 Marzo | 8 | 16 | 24 |
| 2015 Febrero | 4 | 12 | 16 |
| 2015 Enero | 8 | 4 | 12 |
| 2014 Diciembre | 9 | 12 | 21 |
| 2014 Noviembre | 7 | 2 | 9 |
| 2014 Octubre | 13 | 8 | 21 |
| 2014 Septiembre | 10 | 1 | 11 |
| 2014 Agosto | 8 | 2 | 10 |
| 2014 Julio | 13 | 2 | 15 |
| 2014 Junio | 8 | 6 | 14 |
| 2014 Mayo | 4 | 3 | 7 |
| 2014 Abril | 5 | 4 | 9 |
| 2014 Marzo | 9 | 1 | 10 |
| 2014 Febrero | 3 | 7 | 10 |
| 2014 Enero | 5 | 2 | 7 |
| 2013 Diciembre | 5 | 2 | 7 |
| 2013 Noviembre | 9 | 7 | 16 |
| 2013 Octubre | 1 | 2 | 3 |
| 2013 Septiembre | 4 | 3 | 7 |
| 2013 Agosto | 2 | 4 | 6 |
| 2013 Julio | 1 | 1 | 2 |
| 2009 Marzo | 340 | 0 | 340 |
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