Life and Health Sciences Research Institute, ICVS/3B's - Associate Lab. School of Medicine - University of Minho.
Urology Department, Hospital de Braga, Braga, Portugal.
Curr Opin Urol. 2021 Jan;31(1):18-23. doi: 10.1097/MOU.0000000000000836.
The aim of this study was to review recent development in urethra and ejaculation preserving laparoscopic and robotic simple prostatectomy.
Since Madigan prostatectomy original description in 1990, to recent reports of robotic-assisted surgery using this urethra-sparing technique, many studies have suggested the advantages of the preservation of urethra, bladder neck and ejaculatory ducts, when removing adenomatous tissue in benign prostatic obstruction (BPO) surgery. Allying anatomical preservation of this structure with the well known benefits of minimally invasive procedures seems to reduce postoperative haematuria, obviating the need for bladder irrigation, with shorter catheterization and hospitalization times, less risk of urethral stricture and, of utmost importance, reducing rates of retrograde ejaculation.
Urethra and bladder neck sparing techniques, especially in minimally invasive simple prostatectomy procedures, seem to provide real benefits, not only in the maintenance of preoperative potency and antegrade ejaculation but also accomplishing better perioperative outcomes, with faster patient recovery, and less complications. These techniques might well be the future standard techniques for sexually active men with large benign prostatic hyperplasia (BPH) requiring surgery.
本研究旨在回顾最近在尿道和射精保留腹腔镜和机器人单纯前列腺切除术方面的进展。
自 1990 年 Madigan 前列腺切除术首次描述以来，到最近使用这种尿道保留技术的机器人辅助手术报告，许多研究表明，在良性前列腺梗阻（BPO）手术中切除腺瘤组织时保留尿道、膀胱颈部和射精管的优势。将这些结构的解剖学保留与微创程序的显著优势结合起来，似乎可以减少术后血尿，避免膀胱冲洗的需要，同时缩短导管插入和住院时间，降低尿道狭窄的风险，最重要的是，降低逆行射精的发生率。
尿道和膀胱颈部保留技术，特别是在微创单纯前列腺切除术手术中，似乎提供了真正的益处，不仅在维持术前勃起和顺行射精方面，而且在实现更好的围手术期结果方面，患者恢复更快，并发症更少。这些技术可能成为需要手术的有性生活的大体积良性前列腺增生（BPH）男性的未来标准技术。
