Penile reinnervation as a new technique for treating erectile dysfunction in patients after radical prostatectomy








https://doi.org/10.21886/2308-6424-2020-8-4-135-144
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Abstract
Nowadays, radical prostatectomy (RPE) is the «gold standard» in the treatment of localized prostate cancer (PCa). However, this intervention is associated with a high risk of developing iatrogenic erectile dysfunction (ED), which significantly reduces the quality of life of a man. One of the surgical solutions to this complication is the installation of a penile prosthesis. Nevertheless, it must be borne in mind that this manipulation is associated with certain risks of intra-and postoperative complications. During the operation, there may be complications such as perforation (cavernous, septal, urethral), crossover (intersection of rods or cylinders), haemorrhage, difficulties in suturing the operating wound, damage to the components of the prosthesis. The most common problem is an infection in the postoperative period. It is also worth noting the high cost of implants and artificial erection, which is crucial for some young patients. Countries around the world are searching for new methods to restore physiological erectile function in patients after RPE. Recently, the attention of specialists has been drawn to the possibility of restoring the innervation of the penis by transplanting a nerve graft. The study aimed to provide a general idea of the ED treatment in patients after RPE by nerve graft transplantation with the development and realization of our own described at the end as a clinical case.
About the Authors
S. V. PopovRussian Federation
Sergey V. Popov — M.D., Dr.Sc.(M), Full Prof.; Prof., Dept. of Urology, S.M. Kirov Military Medical Academy; Chief Medical Officer, St. Luke Clinical Hospital
194044, St. Petersburg, 46 Chugunnaya st.; 194044, St. Petersburg, 6 Academician Lebedev st.
Competing Interests: Authors declare no conflict of interest.
I. N. Orlov
Russian Federation
Igor N. Orlov — M.D., Cand.Sc.(M); Head, Urological Division No.1, City Centre of Endoscopic Urology and New Technologies, St. Luke Clinical Hospital; Assist., Dept. of Urology, Mechnikov North-Western State Medical University.
194044, St. Petersburg, 46 Chugunnaya st.
Competing Interests: Authors declare no conflict of interest.
A. M. Gul'ko
Russian Federation
Alexander M. Gul'ko — M.D.; Urologist, Urological Division No.1, City Centre of Endoscopic Urology and New Technologies, St. Luke Clinical Hospital.
194044, St. Petersburg, 46 Chugunnaya st.
tel.: +7 (911) 288-22-92
Competing Interests: Authors declare no conflict of interest.
G. V. Medvedev
Russian Federation
German V. Medvedev - M.D.; Junior Research Assistant, R.R. Vreden Russian Scientific Research Institute of Traumatology and Orthopedics.
195427, St. Petersburg, 8 Academician Baykova st.
Competing Interests: Authors declare no conflict of interest.
I. O. Shemiakin
Russian Federation
Igor O. Shemiakin — Resident, Dept. of Thermal Injuries and Plastic Surgery, S.M. Kirov Military Medical Academy.
194044, St. Petersburg, 6 Academician Lebedev st.
Competing Interests:
Authors declare no conflict of interest.
D. N. Solomitskiy
Russian Federation
Denis N. Solomitskiy - Resident, Dept. of Thermal Injuries and Plastic Surgery, S.M. Kirov Military Medical Academy.
194044, St. Petersburg, 6 Academician Lebedev st.
Competing Interests: Authors declare no conflict of interest.
T. M. Topuzov
Russian Federation
Timur M. Topuzov — M.D., Cand.Sc.(M); Urologist, Urological Division No.1, City Centre of Endoscopic Urology and New Technologies, St. Luke Clinical Hospital
194044, St. Petersburg, 46 Chugunnaya st.
Competing Interests: Authors declare no conflict of interest.
M. L. Gorelik
Russian Federation
Maksim L. Gorelik — Resident, Urological Division No.1, City Centre of Endoscopic Urology and New Technologies, St. Luke Clinical Hospital
194044, St. Petersburg, 46 Chugunnaya st.
Competing Interests: Authors declare no conflict of interest.
A. V. Semenyuk
Russian Federation
Andrey V. Semenyuk — Resident, Urological Division No.1, City Centre of Endoscopic Urology and New Technologies, St. Luke Clinical Hospital
194044, St. Petersburg, 46 Chugunnaya st.
Competing Interests: Authors declare no conflict of interest.
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Review
For citations:
Popov S.V., Orlov I.N., Gul'ko A.M., Medvedev G.V., Shemiakin I.O., Solomitskiy D.N., Topuzov T.M., Gorelik M.L., Semenyuk A.V. Penile reinnervation as a new technique for treating erectile dysfunction in patients after radical prostatectomy. Urology Herald. 2020;8(4):135-144. (In Russ.) https://doi.org/10.21886/2308-6424-2020-8-4-135-144