EXTRAPERITONEOSCOPIC PROSTATEСTOMY: SURGICAL TECHNIQUES PRESERVING THE QUALITY OF LIFE OF THE PATIENT

Objective.Radical prostatectomy (RPE) performed without preserving the neurovascular bundles and the pubovesical complex has a great risk of developing urinary incontinence and erectile dysfunction, which significantly impairs the quality of life of patients with prostate cancer in the postoperative period. Methods. The effectiveness of surgical treatment was assessed in 22 patients (mean age 57.6 ± 6.4 years) with a diagnosis of prostate cancer, who underwent extraperitoneoscopic intrafascial nerve-saving radical prostatectomy with preservation of the pubovesical complex. The criteria for the effectiveness of this technique of surgical treatment were considered the preservation of erectile function and the absence of urinary incontinence in the early and late postoperative period. Results. In the postoperative period, all patients were continent; in 3-4 months, erectile function was restored without additional stimulation by phosphodiesterase-5 inhibitors. Conclusions.The described technique demands detailed understanding by the surgeon of the surgical anatomy of the prostate and the basic surgical principles of nerve preservation in order to significantly improve the quality of life of patients in the postoperative period.

prostate cancer, surgical treatment, erectile function, pubovesical complex, IIEF-5