Braslis K G, Petsch M, Lim A, Civantos F, Soloway M S
Department of Urology, University of Miami School of Medicine, Fla 33101, USA.
Eur Urol. 1995;28(3):202-8. doi: 10.1159/000475052.
Between December 1991 and January 1994, 134 patients underwent radical retropubic prostatectomy with bladder neck preservation. Forty-nine patients had a positive margin. Number and location of positive margins were analyzed. A tumor was identified at the bladder neck in 10 cases (7.5%). In all 10 patients with bladder neck involvement, a tumor was also identified at multiple other sites. These data suggest that preservation of the bladder neck during radical prostatectomy does not appear to compromise the efficacy of the procedure. Using a self-administered patient questionnaire, we evaluated the effect of bladder neck preservation upon continence in 36 patients. At the initial 3-month follow-up, 24 (67%) patients did not wear any pads. Another 7 (19%) wore pads occasionally, while 5 (14%) patients wore pads daily. To date only 1 of the 134 patients has developed an anastomotic stricture. Bladder neck preservation may aid in an earlier return of continence following radical prostatectomy and reduces anastomotic strictures. It does not appear to compromise the removal of the cancer.
1991年12月至1994年1月期间，134例患者接受了保留膀胱颈的耻骨后根治性前列腺切除术。49例患者切缘阳性。对切缘阳性的数量和位置进行了分析。10例（7.5%）患者在膀胱颈处发现肿瘤。在所有10例膀胱颈受累患者中，在其他多个部位也发现了肿瘤。这些数据表明，根治性前列腺切除术中保留膀胱颈似乎不会影响手术效果。我们使用患者自行填写的问卷，对36例患者保留膀胱颈对控尿的影响进行了评估。在最初的3个月随访中，24例（67%）患者无需使用任何尿垫。另外7例（19%）患者偶尔使用尿垫，而5例（14%）患者每天使用尿垫。迄今为止，134例患者中仅有1例出现吻合口狭窄。保留膀胱颈可能有助于根治性前列腺切除术后控尿功能更早恢复，并减少吻合口狭窄。它似乎不会影响癌症的切除。
