Эякуляторно-протективные методики в хирургическом лечении гиперплазии предстательной железы

Введение. Ретроградная эякуляция имеет множество хорошо описанных причин, от фармакологических нарушений до вмешательства в механизмы иннервации при оперативном лечении гиперплазии предстательной железы (ГПЖ).

Цель исследования. Изучить вопрос анатомо-физиологических особенностей ретроградной эякуляции и проанализировать накопленный научный материал, посвящённый частоте сохранения антеградной эякуляции после различных эякуляторно-протективных техник на основании современной медицинской литературы.

Материалы и методы. Проведён обзор литературы с использованием баз данных PubMed, Medline и Scopus за период с 1966 по 2024 год. Для дифференциального поиска использованы ключевые слова «гиперплазия предстательной железы», «ретроградная эякуляция», «эякуляторно-протективные техники», «трансуретральная энуклеация», «оценка эякуляторных расстройств», «физиология эякуляции». Проработаны 1123 источника литературы, в обзор включена 51 работа.

Результаты. Определены основные взгляды на анатомо-физиологическую составляющую ретроградной эякуляции и методы субъективной оценки эякуляторных расстройств, а также освещены современные эякуляторно-протективные техники и альтернативные методы хирургического лечения ГПЖ. Высокотехнологичная медицинская помощь в лечении ГПЖ уже сегодня дарит шанс пациентам после трансуретральных операций иметь детей, благодаря чему запрос пациента сегодня – исчезновение симптомов заболевания, а также повышение удовлетворённости жизнью в психоэмоциональном и социальном аспектах.

Заключение. Разработка и применение эякуляторно-протективных методик значительно повышает социальную и психоэмоциональную оценку пациентов, перенёсших оперативное лечение по поводу ГПЖ. В связи с этим требуется дальнейшее изучение проблемы ретроградной эякуляции, проведение научно-практических исследований, а также разработка новых методик хирургического лечения ГПЖ для нивелирования данного послеоперационного осложнения.

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