Morpho-Anatomic Substantiation of Early Continence after Radical Prostatectomy
Keywords:radical prostatectomy, continence, dorsal venous complex, external urethral sphincter, morphometric study
Introduction. In modern conditions, the radical prostatectomy should provide not only good oncological results, namely, the absence of a positive surgical margin in the removed preparation and biochemical recurrence in the postoperative period, but also the complete functional rehabilitation of the patient. When performing radical prostatectomy in order to prevent bleeding before dissection, suturing of the dorsal venous complex is preformed, or its separation followed by ligation, which improves the visualization at this stage of the surgery. At the same time, a number of authors argue that any intervention in this area anyhow leads to injury of external urethral sphincter. The aim of our study was to investigate the possibility of processing (suturing, ligation) the dorsal venous complex without traumatizing external urethral sphincter by comprehensive morphological and anatomical study of the structures of dorsal venous complex and its relationship to the external urethral sphincter according to pathological, histochemical, morphometric, immunohistochemical studies and analysis of their composition. Materials and methods. The characteristics of surgical anatomy of the dorsal venous complex and external urethral sphincter were studied on 30 specimens taken from the corpses of men of all ages and body types, who died of causes unrelated to cardiovascular diseases. Results and discussion. Morphometric analysis has shown that the average distance between the dorsal venous complex and the external urethral sphincter was 65.76 ± 8.26 μm that is more than half (43.3 %) less than the diameter of the needles. Conclusions. The data of comprehensive study indicate that suturing or ligation of the dorsal venous complex is not possible without the injury of external urethral sphincter.
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