Otvorena radikalna prostatektomija sa i bez poštede neurovaskularnog snopa: korelacije između Internacionalnog indeksa erektilne funkcije i elektromiografije kavernoznih tela

  • Saša Vojinov University Clinical Center of Vojvodina, Clinic of Urology, Novi Sad, Serbia; †University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Dimitrije Jeremić University Clinical Center of Vojvodina, Clinic of Urology, Novi Sad, Serbia; †University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Ivan Levakov University Clinical Center of Vojvodina, Clinic of Urology, Novi Sad, Serbia; †University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Jovo Bogdanović University Clinical Center of Vojvodina, Clinic of Urology, Novi Sad, Serbia; †University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Mladen Popov University Clinical Center of Vojvodina, Clinic of Urology, Novi Sad, Serbia; †University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Stevan Stojanović University Clinical Center of Vojvodina, Clinic of Urology, Novi Sad, Serbia; †University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Srdjan Govedarica University Clinical Center of Vojvodina, Clinic of Urology, Novi Sad, Serbia; †University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
DOI: https://doi.org/10.2298/VSP250828077V
Ključne reči: elektromiografija;, erektilna disfunkcija;, penis, erekcija;, prostatektomija;, prostata, neoplazme.

Sažetak


Uvod/Cilj. Erektilna disfunkcija (ED) se povećava sa godinama, a značaj seksualnog zdravlja postao je sve rasprostranjeniji u terapeutskoj praksi. Cilj rada bio je da se proceni korelacija između subjektivnih i objektivnih parametara ED kod bolesnika koji su podvrgnuti otvorenoj radikalnoj prostatektomiji, sa i bez poštede neurovaskularnog snopa, zbog lokalizovanog karcinoma prostate. Metode. Prospektivna kontrolisana studija obuhvatila je 50 bolesnika sa dijagnostikovanim karcinomom prostate i normalnom preoperativnom erektilnom funkcijom (EF). Bolesnici su podeljeni u grupu sa poštedom neurovaskularnog snopa (n = 25) i grupu bez poštede neurovaskularnog snopa (n = 25). EF je procenjivana preoperativno i nakon šest meseci korišćenjem upitnika za procenu Internacionalnog indeksa eretkilne funkcije (IIEF), dok je elektromiografija kavernoznih tela registrovala spontanu aktivnost glatkih mišića. Statistička analiza uključivala je upareni t-test i Spearmanove korelacije. Rezultati. Postoperativni rezultati IIEF su se značajno smanjili u obe grupe (poštedna tehnika: 22,04 ± 2,10 na 17,87 ± 3,83, p < 0,001; nepoštedna tehnika: 21,67 ± 2,64 na 6,42 ± 1,51, p < 0,001). Bilateralna pošteda neurovaskularnog snopa očuvala je superiorniju EF u poređenju sa unilateralnom tehnikom (19,87 ± 2,80 vs.14,13 ± 2,42, p < 0,001). Nije nađena značajna korelacija između parametara elektromiografije kavernoznog tela (amplituda, srednji talas, fazni preokreti i rezultata IIEF (p > 0,05). Zaključak. Otvorena radikalna prostatektomija sa poštedom neurovaskularnog snopa, naročito bilateralna tehnika, značajno smanjuje težinu ED. Međutim, elektromiografija kavernoznih tela nije korelirala sa ishodima koje su prijavili bolesnici, što ukazuje na njenu ograničenu samostalnu primenljivost u postoperativnoj proceni ED.

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2025/12/26
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Vol. 82 Br. 12 (2025): Vojnosanitetski pregled
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