Radical prostatectomy with preservation of sexual function: Anatomical and pathological considerations

Prostate - Tập 4 Số 5 - Trang 473-485 - 1983
Patrick C. Walsh1, Herbert Lepor1, Joseph C. Eggleston1
1James Buchanan Brady Urological Institute, Johns Hopkins Hospital, and the Departments of Urology and Pathology, Johns Hopkins University School of Medicine, Baltimore

Tóm tắt

AbstractThe technique for radical retropubic prostatectomy has been modified to avoid injury to the branches of the pelvic plexus that innervate the corpora cavernosa. The surgical procedure is based on an understanding of the anatomical relationships between the branches of the pelvic plexus that innervate the corpora cavernosa, the capsular branches of the prostatic vessels that provide the scaffolding for these nerves, and the lateral pelvic fascia. The modifications involve two steps in the procedure: 1) the incision in the lateral pelvic fascia is placed anterior to the neurovascular bundle, which is located dorsolateral to the prostate along the pelvic sidewall; 2) the lateral pedicle is divided close to the prostate to avoid injury to the branches of the pelvic plexus that accompany the capsular vessels of the prostate. Pathologic evaluation of 16 prostatic specimens removed by this modified procedure demonstrated no compromise in the adequacy of the surgical margins. Postoperative sexual function was evaluated in 12 men who underwent the procedure 2‐10 months previously. All have experienced erections and six have achieved successful vaginal penetration and orgasm. Of the six patients with sexual partners who have been followed 6 months or longer, five (83%) are fully potent. These data indicate that it is possible to cure localized prostatic cancer with surgery and maintain postoperative sexual function.

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Tài liệu tham khảo

10.1001/jama.203.6.403

10.1016/S0022-5347(17)62019-6

10.1016/S0022-5347(17)58449-9

10.1016/S0022-5347(17)58448-7

10.1016/S0022-5347(17)55035-1

10.1016/S0022-5347(17)53012-8

Gray H, 1959, Anatomy of the Human Body, 1055

10.1016/S0022-5347(17)72052-6

Clegg EJ, 1955, The arterial supply of the human prostate and seminal vesicles, J Anat, 89, 209

10.1016/S0022-5347(17)61201-1

Uhlenhuth E, 1953, Problems in the Anatomy of the Pelvis, An Atlas, 17

Young HH, 1926, Young's Practice of Urology, 463

10.1016/0090-4295(83)90127-9

10.1016/S0022-5347(17)56718-X

Zwartendijk J, 1979, Current and Future Trends in Urology, 102

Walsh PC, Campbell's Urology

Weyrauch HM, 1959, Surgery of the Prostate, 221

10.1016/0090-4295(75)90798-0

10.1016/S0022-5347(17)55034-X

10.1016/S0015-0282(16)42131-X

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Thông tin xuất bản

Prostate

Tập 4 Số 5

473-485

Thông tin tác giả