Pushkar' D Iu, Bormotin A V, Rasner P I
Urologiia. 2007 Jan-Feb(1):5-10.
Radical retropubic prostatectomy (RPPE) for local prostatic cancer was made in 226 patients. Neurovascular bundles were preserved on one or both sides in 68 (30%) of them. Sixty one (90%) of these patients filled in questionnaires. In 37 (61%) of them the bundles were preserved unilaterally, in 24 (39%)--bilaterally. Only 7 (19%) patients had 4-5 score erection after unilateral nerve-preserving RPPE, 16 (43%) had tumescence. 0 score tumescence was detected in 14 (38%) patients of this group. Thirteen (54%) patients after RPPE with bilateral preservation of the bundles had 4-5 score erection. 0 score erection was in 3 (12%) patients of this group. Comparison of the patients under and over 60 years of age has shown that younger patients' erectile function recovers more quickly: in unilateral nerve-preserving RPPE in 20 and 12%, respectively; in bilateral operation--in 47 and 39%, respectively. Thus, erectile function can be preserved in patients after RPPE in careful preoperative selection of the candidates and in conduction of surgery meeting all modern requirements.
对226例局部前列腺癌患者实施了耻骨后根治性前列腺切除术(RPPE)。其中68例(30%)患者一侧或双侧保留了神经血管束。这些患者中有61例(90%)填写了问卷。其中37例(61%)患者单侧保留神经血管束,24例(39%)患者双侧保留。单侧保留神经的RPPE术后,只有7例(19%)患者勃起功能评分为4 - 5分,16例(43%)患者有阴茎肿胀。该组14例(38%)患者阴茎肿胀评分为0分。双侧保留神经血管束的RPPE术后,13例(54%)患者勃起功能评分为4 - 5分。该组3例(12%)患者勃起功能评分为0分。对60岁及以上和60岁以下患者的比较表明,年轻患者的勃起功能恢复更快:单侧保留神经的RPPE术后分别为20%和12%;双侧手术分别为47%和39%。因此,在对患者进行仔细的术前筛选并进行符合所有现代要求的手术时,RPPE术后患者的勃起功能可以得到保留。