Анатомия сосудисто-нервного пучка и методы ее сохранения при нервосберегающей простатэктомии

Обеспечение высокого качества жизни мужчины после выполнения радикальной простатэктомии по поводу рака предстательной железы (РПЖ) в настоящее время является одной из актуальных проблем урологии и андрологии. Нервосберегающая радикальная простатэктомия является одной из высокотехнологичных операций в урологии, и задача хирурга состоит не только в удалении опухоли предстательной железы, но и в обеспечении высокого качества жизни пациента. О важности и актуальности данной проблемы свидетельствует тот факт, что именно ей посвящено большинство вопросов, возникающих у больных в беседе с хирургом еще до хирургического вмешательства.

Национальный институт здравоохранения США показывает, что прирост заболеваемости РПЖ ежегодно составляет около 9,5%, а локализованная форма стала встречаться у более молодых мужчин. В связи с этим перед хирургом стоит задача не только излечить пациента от злокачественного образования, но и сохранить эректильную функцию и показатели континенции, тем самым улучшить качество жизни.

На современном этапе диагностические методы дают возможность значительно чаще обнаруживать ранний рак предстательной железы, благодаря чему выявление и лечение таких пациентов стало более доступным и позволяет применить данную операцию. Однако для сохранения сосудисто-нервного пучка обязательным является знание анатомических особенностей данной зоны.

За последние несколько десятилетий проведены анатомические исследования, которые описали нейроанатомию предстательной железы и прилегающей ткани. В этой статье кратко изложены последние результаты исследований нейроанатомических исследований, некоторые из которых противоречат установленному консенсусу в отношении анатомии таза.

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