LeFrak Institute of Robotic Surgery and Prostate Cancer Institute, James Buchanan Brady Foundation Department of Urology, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, USA.
Curr Opin Urol. 2012 Mar;22(2):88-96. doi: 10.1097/MOU.0b013e3283501826.
Much of the progress in improving potency outcomes after radical prostatectomy has been achieved due to a better visualization of the neurovascular bundle responsible for erectile function. We review the current literature evaluating the existing imaging modalities to image the neurovascular bundle around the prostate pre, intra, and postoperatively, thereby enabling development of surgical techniques for better preservation of nerve function.
Imaging modalities like multiphoton microscopy, optical coherence tomography, Coherent anti-Raman spectroscopy, exogenous fluoroscopy using prostate-specific membrane antigen, and so on have led to a better appreciation of the neurovascular bundle, thus encouraging novel techniques in nerve preservation during radical prostatectomy.
In an age of heightened patient expectations and increasing life expectancy, better visualization of the neurovascular bundle around the prostate using novel imaging modalities may provide breakthroughs in improving potency outcomes after radical prostatectomy.
由于更好地观察到负责勃起功能的神经血管束,根治性前列腺切除术后提高勃起功能的效果有了很大的改善。我们回顾了现有的评估各种成像方式的文献,这些成像方式可在前列腺的术前、术中和术后对神经血管束进行成像,从而为更好地保留神经功能的手术技术的发展提供了可能。
多光子显微镜、光相干断层扫描、相干反斯托克斯拉曼光谱、前列腺特异性膜抗原的外源性荧光透视等成像方式使人们对神经血管束有了更好的了解,从而鼓励在根治性前列腺切除术中采用新的神经保护技术。
在患者期望提高和预期寿命延长的时代,使用新型成像方式更好地观察前列腺周围的神经血管束,可能会为改善根治性前列腺切除术后的勃起功能结果带来突破。