A histological study of Denonvilliers' fascia and its relationship to the neurovascular bundle

Objective To evaluate the anatomical relationship between the nerves and fasciae at the site of dissection in a radical retropubic prostatectomy. Materials and method Eight adult male (autopsy) en bloc specimens of bladder and rectum were examined histologically after staining with either haematoxylin and eosin or S-100 protein (as a specific nerve stain). Results All specimens showed Denonvilliers' fascia to have no clearly defined layers and no definable lateral edge. No distinct neurovascular bundle was seen but nerves were scattered throughout the fasciae, including medially towards the midline. Conclusion In radical retropubic prostatectomy, a piece of Denonvilliers' fascia is taken with the specimen, thus removing these nerves, The loss of these nerve fibres may explain the significant rate of erectile dysfunction after 'nerve-sparing' surgery.