Making anatomic terminology of the prostate and contiguous structures clinically useful: historical review and suggestions for revision in the 21st century

Abstract

Herein we review nomenclature of the prostate and contiguous structures in each of the 10 official publications from the 1895 [Basel] Nomina Anatomica to the 1998 Terminologia Anatomica. We then compare existing clinical terminology with official terminology endorsed by anatomists over the years with a goal to modernize official terminology. Problematic terms, namely, lobes and lobuli, fascia versus capsule, Denonvilliers' fascia, and transition versus periurethral zone, are addressed. The idea of recognizing prostate arteries, veins, nerves, and neurovascular bundles is introduced. Prostatic and membranous urethras and the closely related external urethral sphincter are covered. We believe urogenital hiatus should also be called anterior levator hiatus. Trapezoid zone should be discarded in future editions of nomenclature. Our recommended changes are supported by a series of pertinent photographs of gross and whole mount histologic specimens and magnetic resonance images. Finally, we provide a new table of terms for the prostate with recommended amendments and deletions to existing official nomenclature as contained in the 1998 Terminologia Anatomica.