ABSTRACT

This is the first critical point where the bundles may be damaged. Because the neurovascular bundle when approaching the prostatic apex is located underneath the sphincter and can be fixated into a medial position by an apical vessel, care is used to transect only the lateral edges of the sphincter at the urethral level, refraining from any dissection underneath the prostatic apex. 10 Subsequently, the dissection of the bundle is carried out starting at the bladder neck and proceeding down to the apex until a groove appears on the posterolateral edge of the prostate that serves as a landmark for the neurovascular bundle, which is located just laterally to it. Following the groove down to the apex will enable the identification of the bundles at the level of the transected urethra: only at this point can the dissection be completed at the apex and carried out posterior to develop the prostatic – rectal plane without damaging the nerves.