保留“堤坝式”前列腺腹侧筋膜对膀胱癌根治术后患者勃起功能的影响

Abstract

Abstract:

Objective　To study the values of "dam-sparing" of prostatic ventral fascia in radical cystectomy,and the effect on erectile function in patients postoperatively.　Methods　40 male patients of invasive bladder cancer, the scores of Sexual Health Inventory for Men ≥22 in all patients preoperatively.And then received radical cystectomy.23 cases received the traditional operative methods of bilateral neurovascular bundle sparing in radical cystectomy (A group),17 cases received the traditional methods of bilateral neurovascular bundle sparing combined with "dam-sparing" of prostatic ventral fascia in radical cystectomy.Data on postoperative sexual function were collected at 6、12 months, compared the early postoperative erectile functional rehabilitation between the two groups.　Results　Based on the results of Sexual Health Inventory for Men score, at 6 months postoperatively: 17 cases in A group and 15 cases in B group achieved score of 17 or greater（73.9% vs 88.2%,P＜0.05）. 11 cases in A group and 12 cases in B group achieved score of 22 or greater（47.8% vs 70.6%, P＜0.05）. at 12 months postoperatively, 18 cases in A group and 17 cases in B group achieved score of 17 or greater（78.3% vs 100%，P＜0.05）, 11 cases in A group and 12 cases in B group achieved score of 22 or greater（56.5% vs 82.4%，P＜0.05）.　Conclusions　"dam-sparing" of prostatic ventral fascia combined with traditional methods of bilateral neurovascular bundle sparing in radical cystectomy would markedly improve postoperative erectile function in radical cystectomy.

Key words: Prostatic fascia, Radical cystectomy, Erectile function

CLC Number:

R697.3

LUO Xiang-Ning, CHEN Ling-Wu, CHEN Dun-Xing, LIN Huan-Yi, DENG Nan. Values of "dam-sparing" of Prostatic Ventral Fascia in Radical Cystectomy and Effect on Erectile Function in Patients Postoperatively[J]. Chinese Journal Of Clinical Anatomy, 2013, 31(3): 342-345.

References

[1] Nordstr?觟m GM, Nyman CR. Male and female sexual function and activity following ileal conduit urinary diversion
[J]. Br JUrol, 1992,70(1): 33-42.

[2] Cosciani Cunico S, De Luca V, Thaer B, et al. Sex-dynamic characterization of patients subjected to radical pelvic cavity surgery
[J]. Arch Ital Urol Androl, 1994, 66(1):11-14.

[3] 梅骅,陈凌武,高新.泌尿外科手术学
[M]. 第3版, 北京:人民卫生出版社,2008: 250-257.

[4] Parsons JK, Marschke P, Maples P, et al. Effect of methylprednisolone on return of sexual function after nerve-sparing radical retropubic prostatectomy
[J].Urology, 2004,64(5):987-996.

[5] Walsh PC, Donker PJ. Impotence following radical prostatectomy; insight into aetiology and prevention
[J]. J Urol, 1982, 128(3): 492-497.

[6] Walsh PC, Mostwin JL. Radical prostatectomy and cystoprostatectomy with preservation of potency: results using a new nerve-sparing technique
[J]. Br J Urol, 1984,56(4):694-703.

[7] Schilling A, Friesen A. Transprostatic selective cystectomy with an ileal bladder
[J]. Eur Urol, 1990,18(3):253-264.

[8] Spitz A, Stein JP, Lieskovsky G, et al. Orthotopic urinary diversion with preservation of erectile and ejaculatory function in men requiring radical cystectomy for nonurothelial malignancy: a new technique
[J]. J Urol, 1999,161(6):1761-1772.

[9] Guazzom G, Cestari A, Colombo R, et al. Laparoscopic nerve-and seminal-sparing cystectomy with orthotopic ileal neobladder: the first three cases
[J]. Eur Urol, 2003,44 (5): 567-578.

[10] 黄健,黄海,林天歆,等.保留前列腺包膜的膀胱全切除-原位回肠新膀胱术
[J].现代泌尿生殖肿瘤杂志, 2009, 1(1):4-7.

[11]Lane BR, Finelli A, Moinzadeh A, et al. Nerve-sparing laparoscopic radical cystectomy: technique and initial outcomes
[J]. Urology, 2006, 68(4):778-783.

[12]王志华，陈忠. 临床上能否施行保留生育功能的膀胱癌根治术
[J]. 现代泌尿生殖肿瘤杂志, 2009, 1(1):59-60.

[13]Takenaka A, Murakami G, Soga H, et al. Anatomical analysis of the neurovascular bundle supplying penile cavernous tissue to ensure a reliable nerve graft after radical prostatectomy
[J]. J Urol, 2004, 172(3): 1032–1035.

[14]Kiyoshima K, Yokomizo A, Yoshida T, et al. Anatomical features of periprostatic tissue and its surroundings: a histological analysis of 79 radical retropubic prostatectomy specimens
[J]. Jpn J Clin Oncol, 2004, 34(8):463-468.

[15]Lunacek A, Schwentner C, Fritsch H, et al. Anatomical radical retropubic prostatectomy: ‘curtain dissection’ of the neurovascular bundle
[J]. BJU Int, 2005, 95(5): 1226-1231.

[16] Menon M, Shrivastava A, Kaul S, et al. Vattikuti institute prostatectomy: contemporary technique and analysis of results
[J]. Eur Urol, 2007, 51(3):648-658.

[17]Menon M, Shrivastava A, Bhandari M, et al. Vattikuti institute prostatectomy: technical modifications in 2009
[J]. Eur Urol, 2009, 56(1):89-96.

[18]雒向宁, 陈凌武，关伟明. 前列腺周围神经区间量化分析与前列腺癌手术方式改良的关系
[J].中国临床解剖学杂志, 2012,30(2):157-160.

Values of "dam-sparing" of Prostatic Ventral Fascia in Radical Cystectomy and Effect on Erectile Function in Patients Postoperatively

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 1

Metrics

Comments

Recommended 0