Effect of modified peritoneal laparoscopic whole-fascial radical prostatectomy on erectile function and urodynamics in patients with localized prostate cancer
Objective To investigate the improvement effects of modified peritoneal laparoscopic whole-fascial radical prostatectomy(RP)on erectile function and urodynamics in patients with localized prostate cancer(PCa).Methods A total of 82 patients with localized PCa admitted to Qingyuan Branch of the First Affiliated Hospital of Zhejiang Chinese Medical University from January 2020 to June 2022 were retrospectively selected,and divided into the control group(41 cases)and the observation group(41 cases)according to different intraoperative fascia treatment methods.Both groups received RP by peritoneal laparoscopy,the control group received routine interfascial vaso-nerve bundle preservation during the operation,and the observation group received modified total intrafascial excision during the operation.The surgery-related parameters,erectile function,urodynamics,pain status and complications were compared between the two groups.Results There were no significant differences in operation time,bleeding volume,drainage tube indwelling time,hospital stay and proportion of positive margin between the two groups(P＞0.05).The scores of international index of erectile function-5(IIEF-5)of the two groups after operation were all higher than those before operation at 6 months.The score of IIEF-5 and erectile function recovery rate of the observation group at 6 months after operation were higher than those of the control group,and the score of visual analogue scale(VAS)was lower than that of the control group,the differences were statistically significant(P＜0.05).The maximum bladder capacity(MBC)and maximum urethral closure pressure(MUCP)of the two groups at 6 months after operation were higher than those before operation,and the observation group was higher than the control group.Bladder compliance value(BC),postvoid residual volume(PVR)and detrusor instability rate(DI)at 6 months after operation were lower than those before operation,and the observation group was lower than the control group,the differences were statistically significant(P＜0.05).The incidence of total complications in the observation group was lower than that in the control group at 6 months after operation,and the difference was statistically significant(P＜0.05).Conclusions The application of modified peritoneal laparoscopic whole-fascial RP in patients with localized PCa can promote the recovery of erectile function,reduce pain symptoms,regulate the level of urodynamics,with good safety.
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