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
雒向宁, 陈凌武, 陈俊星, 林焕懿, 邓楠
中国临床解剖学杂志 ›› 2013, Vol. 31 ›› Issue (3) : 342-345.
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
Values of "dam-sparing" of Prostatic Ventral Fascia in Radical Cystectomy and Effect on Erectile Function in Patients Postoperatively
目的 报道保留“堤坝式”前列腺腹侧筋膜在膀胱癌根治术中的应用，及其对患者术后勃起功能的影响。 方法 40例浸润性膀胱癌男性患者，术前勃起功能评分≥22分，均接受膀胱癌根治性切除术，其中23例按传统方式保留双侧神经血管束（A组），17例术中采用前列腺腹侧筋膜“堤坝样”保留法联合传统方式保留双侧神经血管束（B组）。术后6个月、12个月分别对患者进行国际勃起功能问卷式评估，比较两组患者术后勃起功能的早期恢复情况。 结果 根据男性性健康量表评估结果，术后6个月时：≥17分者，A组与B组分别为17例与15例（（73.9% vs 88.2%,P＜0.05）；≥22分者，A组与B组分别为11例与12例（47.8% vs 70.6%, P＜0.05）。术后12个月时，≥17分者，A组与B组分别为18例与17例（78.3% vs 100%，P＜0.05），≥22分者，A组与B组分别为13例与14例（56.5% vs 82.4%，P＜0.05）。 结论 前列腺腹侧筋膜“堤坝样”保留法与保留双侧神经血管束的联合应用，可以显著提高膀胱癌根治术后患者的勃起功能恢复率。
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.
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