scholarly journals Prognostic factors for erectile function recovery in patients after radical prostatectomy.

2020 ◽  
Vol 13 (5) ◽  
pp. 60-62
Author(s):  
R.A. Veliev ◽  
◽  
E.I. Veliev ◽  
E.A. Sokolov ◽  
◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Erectile Function ◽  
Prostate Gland ◽  
Young Patients ◽  
Sexual Life ◽  
Nerve Sparing ◽  
Scientific Publications ◽  
Factors Affecting ◽  
Surgical Access

Introduction. In recent years, there has been an increase in the number of young patients diagnosed with prostate cancer. Therefore, it is important to maximize the preservation of erectile and sexual function for this category of patients after treatment with prostate cancer. Materials and methods. This article presents an analysis of data from 117 patients after radical prostatectomy for prostate cancer 6 months after surgery. We evaluated the effect of surgical access, the use of nerve-saving techniques (NST), and other factors on the restoration of erectile function (ЕF). Results. In addition to the younger age of patients at the time of surgery, as well as the use of nerve-sparing techniques, predictors of better erectile function after surgery include a higher level of erectile function before surgery on the IIEF-EF scale, as well as surgical access - we have revealed the advantage of robotic-assisted surgery on the prostate gland. Discussion. Currently, many scientific publications are devoted to identifying factors affecting the rеcovery of EF after radical prostatectomy, while the authors emphasize the positive effect of the relatively young age of the patient, preserved erectile function before surgery and the absence of concomitant diseases on the restoration of EF. Our study also confirms the importance of the RP method: the best results in the rehabilitation of sexual life were obtained when performing a robot-assisted radical prostatectomy and using a nerve-sparing technique. Conclusions. Further monitoring of patients is required to determine the dependence of the restoration of erectile function on the time elapsed after surgery, as well as to assess the role of risk factors at a later date after surgery.

scholarly journals CHANGING APPROACH TO THE PROSTATE AS THE WAY OF NERVE-SPARING EFFECT IMPROVEMENT IN PATIENTS WITH LAPAROSCOPIC PROSTATECTOMY

2011 ◽  
Vol 2 (1) ◽  
pp. 26-30
Author(s):  
V A Perepechay ◽  
V L Medvedev ◽  
S N Dmitriady ◽  
A V Zozulya ◽  
I I Skorikov ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Erectile Function ◽  
Posterior Approach ◽  
Prostate Gland ◽  
Seminal Vesicles ◽  
Nerve Sparing ◽  
Average Period ◽  
Urine Leak ◽  
Sparing Effect

The use of prostatespecific antigen screening made it possible to detect an earlystage prostate cancer in young men in which nervesparing radical prostatectomy with preservation of erectile function could be performed. Laparoscopic radical prostatectomy (LRPE) is preferred as a nervesparing technique in the treatment of prostate cancer. During the last 2 years 19 patients underwent the modified Brussels technique transperitoneal LRPE, (extrafascial prostatectomy – 17, interfascial – 2). The average period of observation was 10.3 months. 13 of 14 patients were observated more than 6 months. In this group all patients achieved a complete continence, one of the patients remained urine leak with no more than 1 strip a day. Brussels technique provides better control of neurovascular fibers in the seminal vesicles during radical prostatectomy. Posterior approach to the prostate gland should be avoided in the nervesparing LRPE.

scholarly journals Anatomy of the neurovascular bundle and methods of its preservation with nerve-sparing prostatectomy

2018 ◽  
Vol 5 (3) ◽  
pp. 53-66
Author(s):  
H. S. Gevorgyan ◽  
A. A. Kostin ◽  
N. V. Vorobyev ◽  
K. М. Nyushko ◽  
A. G. Muradyan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Prostate Gland ◽  
Neurovascular Bundle ◽  
Diagnostic Methods ◽  
High Tech ◽  
Nerve Sparing ◽  
High Quality

Providing a high quality of life for a man after performing radical prostatectomy for prostate cancer is currently one of the topical problems of urology and andrology. Nervous-protective radical prostatectomy is one of the high-tech operations in urology and the surgeon’s task is not only to remove the tumor of the prostate gland, but also to ensure a high quality of life for the patient. The importance and urgency of this problem is evidenced by the fact that most of the issues that arise in patients in conversation with a surgeon before surgical intervention are devoted to it.The National Institute of Health of the USA shows that the incidence of prostate cancer is about 9.5% per year, and the localized form began to occur in younger men. In this regard, the surgeon faces the task not only to cure the patient of malignant education, but also to maintain the erectile function and the continent’s indicators, thereby improving the quality of life.At the present stage, diagnostic methods make it possible to detect early prostate cancer much more often, so that the identification and treatment of such patients become more accessible and allows the use of this operation. However, for the preservation of the neurovascular bundle, it is mandatory to know the anatomical features of this zone.Over the past few decades, anatomical studies have been conducted that described the neuroanatomy of the prostate and the adjacent tissue. This article summarizes the latest results of studies of neuroanatomical studies, some of which contradict the established consensus on pelvic anatomy.

scholarly journals Case Report: Radical prostatectomy without prostate biopsy in PI-RADS 5 lesions on 3T multi-parametric MRI of the prostate gland

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 54
Author(s):  
Andrew Keller ◽  
Boon Kua
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Prostate Biopsy ◽  
Prostate Gland ◽  
Digital Rectal Examination ◽  
Invasive Procedure ◽  
Positive Margin ◽  
Sufficient Evidence ◽  
Nerve Sparing ◽  
Prostate Biopsies

Objective: Current practice mandates a prostate biopsy for histological confirmation of prostate cancer prior to a radical prostatectomy. Prostate biopsy, whether performed trans-rectally or trans-perineally, is an invasive procedure which typically involves an anaesthetic and has the risks of urosepsis, bleeding and haematoma. Post-biopsy inflammatory changes can also obliterate natural tissue planes thereby potentially compromising the quality of a nerve sparing procedure and increasing positive margin rates.3T-Multi-Parametric Magnetic Resonance Imaging of the Prostate (3T mpMRI-P) is gaining increasing acceptance in the identification and localisation of prostate cancer. In experienced centres, the positive predictive value has been reported to be as high as 95%.Methods: Two patients with rising and elevated age- adjusted PSAs and palpable malignant prostate nodules on Digital Rectal Examination (DRE) underwent 3T mpMRI-P. Both patients had Prostate Imaging-Reporting and Data System (PI-RADS) 5 lesions in their peripheral zones corresponding to palpable nodules. Prostate biopsies were offered but declined by both patients. Both were satisfied that there was sufficient evidence on their PSA, DRE and 3T mpMRI-P for a diagnosis of prostate cancer without prostate biopsies and both elected to proceed to a Da Vinci Robotic Assisted Laparoscopic Radical Prostatectomy (RALRP).Results: Unilateral nerve sparing RALRPs were performed on both patients without complication. Histology demonstrated Gleason 4+4=8 and 4+3=7 prostate adenocarcinomas, with tumour volumes of 14.92cc and 4.5cc respectively.Conclusions: In appropriately counselled patients who have a high pre-test probability of prostate cancer (rising and elevated PSA, malignant nodule on DRE and a corresponding PI-RADS 5 lesion on 3T mpMRI-P), it may be appropriate to proceed to a radical prostatectomy without a tissue diagnosis if the patients have strong reservations about prostate biopsy.

scholarly journals Preoperative Evaluation of Sexual Function in Patients Undergoing Bilateral Nerve-Sparing Radical Retropubic Prostatectomy

2017 ◽  
Vol 10 (1) ◽  
pp. 40-45
Author(s):  
Boyan A. Stoykov ◽  
Nikolay H. Kolev ◽  
Rumen P. Kotsev ◽  
Fahd Al-Shargabi ◽  
Pencho P. Genov ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Sexual Function ◽  
Erectile Function ◽  
Young Patients ◽  
Radical Retropubic Prostatectomy ◽  
University Hospital ◽  
Localized Prostate Cancer ◽  
Nerve Sparing ◽  
Retropubic Prostatectomy ◽  
Number Of Patients

SummaryDuring the last few years, prostate cancer is more frequently diagnosed in young patients. This lays emphasis on the necessity to preoperatively evaluate the sexual function in patients undergoing bilateral nerve sparing radical retropubic prostatectomy (BNSRRP). The aim of our study was to make an objective evaluation of the basic sexual function in patients with clinically localized prostate cancer and candidates for BNSRRP, using internationally validated questionnaires. We also tried to find a correlation between these questionnaires and the individual assessment of candidates, on one hand, and between comorbidities of the patients and degree of erectile dysfunction (ED), on the other hand. From January 2014 to March 2017, at the urology clinic of University Hospital – Pleven, 64 patients opted BNSRRP and reported to have preserved erectile function (EF), wishing to maintain this function after surgery. The patients’ histories and comorbidities were recorded on the day of hospitalization. The subjective assessment of the patients’ potency was compared with International Index of Erectile Function (IIEF). According to the EF domain of the IIEF, baseline EF was assessed in 28 patients. Twelve patients had mild ED, 9 patients had mild to moderate ED, seven patients had moderate, and eight had severe ED. The results showed that a significant number of patients with clinically localized prostate cancer who were candidates for BNSRRP reported to be fully potent but actually had impaired EF preoperatively. There was also a pronounced correlation between concomitant diseases and EF.

Erectile Function Recovery After Nerve-Sparing Radical Prostatectomy for Prostate Cancer: Is Back to Baseline Status Enough for Patient Satisfaction?

2016 ◽  
Vol 13 (4) ◽  
pp. 669-678 ◽  
Author(s):  
Martina Sofia Rossi ◽  
Marco Moschini ◽  
Marco Bianchi ◽  
Giorgio Gandaglia ◽  
Nicola Fossati ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Patient Satisfaction ◽  
Radical Prostatectomy ◽  
Erectile Function ◽  
Nerve Sparing ◽  
Function Recovery ◽  
Baseline Status

scholarly journals Prevention and managment possibilities of erectile dysfunction after radical prostatectomy

2009 ◽  
Vol 150 (18) ◽  
pp. 831-837
Author(s):  
Péter Riesz ◽  
András Rusz ◽  
Miklós Szűcs ◽  
Attila Majoros ◽  
Péter Nyírády ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Erectile Dysfunction ◽  
Radical Prostatectomy ◽  
Early Stage ◽  
Sexual Life ◽  
Nerve Sparing ◽  
Non Invasive ◽  
Younger Age ◽  
Detect Prostate Cancer

Radical prostatectomy is the curative surgical management of organ confined prostate cancer. Erectile dysfunction may follow surgery as the most common complication decreasing the quality of life of the patient. Thanks to spreading PSA screening probabilty increases to detect prostate cancer in its early stage and so the expected number of surgery is increasing, too. Higher number of operation as well as surgery more frequently performed in younger age calls the attention to the importance of erectile dysfunction and its management. Nowadays the physiology of erectile dysfunction due to radical prostatectomy has been revealed, and as a consequence, the nerve sparing surgery for its prevention is already known. The paper presents the different kind of possible invasive and non-invasive treatments of erectile dysfunction, and surveys their history and effectiveness. The erectile function of patients who underwent radical prostatectomy between 1998 and 2007 at the Department of Urology and Urooncological Centre was assessed by IIEF- and MMM questionnaire and letters with questions of habit of medicine taking. The results showe that 59% of patients who require sexual life are capable of it spontaneously or with medical management.

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