The obturator artery

The pudendal artery

The superior vesical artery

The external iliac artery

The inferior vesical artery

Capsular arteries and veins

Hemorrhoidal artery and vein

Santorini plexus

Pudendal artery and vein

Accessory pudendal artery

All of the above

The inferior vesical artery

The obturator artery

The penile artery

The superior vesical artery

S1.

L3-S1.

S2-S4.

T5-T8.

T11-L2.

Inside Denonvilliers fascia

Inside the prostatic fascia

Outside the lateral pelvic fascia

Both inside and outside the prostatic fascia

Between the layers of the prostatic fascia and the levator fascia

The arterial supply to the prostate is ligated early.

Because the perineum is elevated, there is lower venous pressure.

The dorsal vein complex is not divided because the dissection occurs beneath the lateral fascia and anterior pelvic fascia.

There is no need to divide the puboprostatic ligaments.

It is easier to ligate the dorsal vein complex through the perineal approach than through the retropubic approach.

Striated urethral sphincter

Preprostatic sphincter

Bulbar urethra

Levator ani musculature

Bladder neck

The pudendal nerve

The neurovascular bundle

The obturator nerve

The sympathetic fibers from T11 to L2

The accessory pudendal nerve

The obturator vessels

The sacral foramen

The obturator nerve

The pelvic side wall musculature

The hypogastric vein

neurovascular bundle.

obturator artery.

inferior vesical artery.

external iliac artery.

pudendal artery and veins.

Not at all; the puboprostatic ligaments do not need to be divided to perform a radical prostatectomy

Widely enough to permit a right angle to be placed around the dorsal vein complex

Superficially, with just enough incised to expose the junction between the anterior apex of the prostate and the dorsal vein complex

Not at all; the puboprostatic ligaments should be left intact

Extensively, down to the pelvic floor, including the pubourethral component

Both a and b

Aberrant pudendal arteries; impotence

Striated urethral sphincter; incontinence

Neurovascular bundle; impotence

Levator ani musculature; incontinence

Posterolateral; during release of the neurovascular bundle

Apex; during division of the striated urethral sphincterdorsal vein complex

Seminal vesicles

Posterior; when the prostate is dissected from the rectum

Bladder neck; during separation of the prostate from the bladder

Oversewing the proximal dorsal vein complex is not required.

They should be oversewn horizontally to avoid a positive surgical margin.

The edges should be pulled together in the midline to avoid bleeding.

The edges should be oversewn in the shape of a V to avoid advancing the neurovascular bundles too far anteriorly on the prostate.

Bunching sutures should be used to avoid excising too much striated sphincter.

Denonvilliers fascia

Rectourethralis

Neurovascular bundles

Posterior portion of the striated sphincter complex

Rectal fascia