c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Nerve-Sparing Extraperitoneal Lymph Node Dissection: 19

A D V E R T I S E M E N T

   
 

The relationships of the genitourinary structures to the great vessels is shown (see renal anatomy).       

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Nerve-Sparing Extraperitoneal Lymph Node Dissection: 20

A D V E R T I S E M E N T

   
 

The lumbar sympathetic chains, and their contributions to the aortic and hypogastric plexuses are shown. The sympathetics are necessary for ejaculation. Sparing the sympathetics during RPLND results in 99% preservation of ejaculatory function. If a patient has received chemotherapy prior to RPLND, the resulting retroperitoneal desmoplastic reaction makes sympathetic sparing very difficult.      

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Nerve-Sparing Extraperitoneal Lymph Node Dissection: 21

A D V E R T I S E M E N T

   
 

Sympathetic branches from the right chain are shown isolated and encircled with vessel loops.       

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This page was last modified on 10/19/2001.