Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press19110.17650/1726-9776-2012-8-1-109-112REVIEWОБЗОРMETHODS FOR IDENTIFICATION OF THE ELEMENTS OF THE PROSTATE NEUROVASCULAR BUNDLE (A REVIEW OF LITERATURE)МЕТОДЫ ИДЕНТИФИКАЦИИ ЭЛЕМЕНТОВ СОСУДИСТО-НЕРВНОГО ПУЧКА ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ (ОБЗОР ЛИТЕРАТУРЫ)LedyaevD. S.ЛедяевД. С.
Russian Federation
atduev@mail.ruZagainovaE. V.ЗагайноваЕ. В.
Russian Federation
atduev@mail.ruAtduyevV. A.АтдуевВ. А.
Russian Federation
atduev@mail.ruNizhny Novgorod State Medical Academy, Nizhny NovgorodНижегородская ГМА, Нижний Новгород30032012811091123107201431072014https://oncourology.abvpress.ru/oncur/article/view/191

With regard to a considerable number of erective dysfunction after radical prostatectomy and a rise in the number of patients concerned with postoperative potency preservation, the identification of neurovascular bundles (NVB) remains an urgent problem. Different NVB imaging procedures exist today; however, there is now no method that is optimal and able to prevent cavernous nerve injury with high probability and reduce the number of complications. The advantages and disadvantages of these procedures should be determined by the long-term functional results of their use, which were assessed in randomized studies.

С учетом значительного числа больных с эректильной дисфункцией после радикальной простатэктомии и роста числа пациентов, заинтересованных в сохранении потенции после операции, остается актуальной проблема идентификации сосудисто-нервных пучков (СНП). В настоящее время существуют различные методики визуализации СНП, однако оптимальной, позволяющей с высокой вероятностью избежать травмирования кавернозных нервов и снизить количество осложнений, на данный момент нет. Достоинства и недостатки этих методик должны определяться отдаленными функциональными результатами их применения, оцененными в рандомизированных исследованиях.

prostate cancererectile dysfunctionneurovascular bundleрак предстательной железыэректильная дисфункциясосудисто-нервный пучок1. EAU Guides 2011. Guidelines on Prostate Cancer.EAU Guides 2011. Guidelines on Prostate Cancer.2. Пушкарь Д.Ю., Верткин А.Л., Гамидов С.И. Эректильная дисфункция. М.: Ремедиум, 2010.Пушкарь Д.Ю., Верткин А.Л., Гамидов С.И. Эректильная дисфункция. М.: Ремедиум, 2010.3. EAU Guides 2010. Guidelines on male sexual dysfunction: Erectile Dysfunction and Premature Ejaculation.EAU Guides 2010. Guidelines on male sexual dysfunction: Erectile Dysfunction and Premature Ejaculation.4. Коган М.И. Эректильная дисфункция. Ростов-на-Дону: Книга, 2005.Коган М.И. Эректильная дисфункция. Ростов-на-Дону: Книга, 2005.5. Male Sexual Dysfunction. Pathophysiology and treatment. Edited by Fouad R. Kandeel. New York−London: Informa Healthcar, 2007Male Sexual Dysfunction. Pathophysiology and treatment. Edited by Fouad R. Kandeel. New York−London: Informa Healthcar, 20076. Walsh P.C., Donker P.J. Impotence following radical prostatectomy: insight into etiology and prevention. J Urol 1982; 128(3):492−7.Walsh P.C., Donker P.J. Impotence following radical prostatectomy: insight into etiology and prevention. J Urol 1982; 128(3):492−7.7. Klotz L. Intraoperative cavernous nerve stimulation during nerve sparing radical prostatectomy: how and when? Curr Opin Urol 2000;10:239−43.Klotz L. Intraoperative cavernous nerve stimulation during nerve sparing radical prostatectomy: how and when? Curr Opin Urol 2000;10:239−43.8. Klotz L., Herschorn S. Early experience with intraoperative cavernous nerve stimulation with penile tumescence monitoring to improve nerve sparing during radical prostatectomy. Urology 1998; 52(4):537–42.Klotz L., Herschorn S. Early experience with intraoperative cavernous nerve stimulation with penile tumescence monitoring to improve nerve sparing during radical prostatectomy. Urology 1998; 52(4):537–42.9. Klotz L., Hearton J., Jewett M. et al. A Randomized phase 3 study of intraoperative cavernous nerve stimulation with penile tumescence monitoring to improve nerve sparing during radical prostatectomy. J Urol 2000;164:1573−8.Klotz L., Hearton J., Jewett M. et al. A Randomized phase 3 study of intraoperative cavernous nerve stimulation with penile tumescence monitoring to improve nerve sparing during radical prostatectomy. J Urol 2000;164:1573−8.10. Gianduzzo T.R., Colombo J.R., El-Gabry E. et al. Anatomical and electrophysiological assessment of the canine periprostatic neurovascular anatomy: perspectives as a nerve sparing radical prostatectomy model. J Urol 2008; 179(5):2025−9.Gianduzzo T.R., Colombo J.R., El-Gabry E. et al. Anatomical and electrophysiological assessment of the canine periprostatic neurovascular anatomy: perspectives as a nerve sparing radical prostatectomy model. J Urol 2008; 179(5):2025−9.11. Walsh P.C., Marschke P., Catalona W.J. et al. Efficacy of first-generation CaverMap to verify location and function of cavernous nerves during radical prostatectomy: A multi-institutional evaluation by experienced surgeons. Urology 2001; 57:491−4.Walsh P.C., Marschke P., Catalona W.J. et al. Efficacy of first-generation CaverMap to verify location and function of cavernous nerves during radical prostatectomy: A multi-institutional evaluation by experienced surgeons. Urology 2001; 57:491−4.12. Kurokawa K., Suzuki T., Suzuki K. et al. Preliminary results of a monitoring system to confirm the preservation of cavernous nerves. Int J Urol 2003;10:136−40.Kurokawa K., Suzuki T., Suzuki K. et al. Preliminary results of a monitoring system to confirm the preservation of cavernous nerves. Int J Urol 2003;10:136−40.13. Велиев Е.И., Голубцова Е.Н., Котов С.В. Восстановление удержания мочи у пациентов после радикальной позадилонной простатэктомии: роль нервосберегающей техники. Урология 2011;(3):68−71.Велиев Е.И., Голубцова Е.Н., Котов С.В. Восстановление удержания мочи у пациентов после радикальной позадилонной простатэктомии: роль нервосберегающей техники. Урология 2011;(3):68−71.14. Takenaka A., Tewari A., Hara R. et al. Pelvic autonomic nerve mapping around the prostate by intraoperative electrical stimulation with simultaneous measurement of intracavernous and intraurethral pressure. J Urol 2007;177(1):225–9.Takenaka A., Tewari A., Hara R. et al. Pelvic autonomic nerve mapping around the prostate by intraoperative electrical stimulation with simultaneous measurement of intracavernous and intraurethral pressure. J Urol 2007;177(1):225–9.15. Fried N.M., Rais-Bahrami S., Lagoda G.A. et al. Identification and imaging of the nerves responsible for erectile function in rat prostate, in vivo, using optical nerve stimulation and optical coherence tomography. IEEE Journal of Selected Topics in Quantum Electronics 2007;13:1641–5.Fried N.M., Rais-Bahrami S., Lagoda G.A. et al. Identification and imaging of the nerves responsible for erectile function in rat prostate, in vivo, using optical nerve stimulation and optical coherence tomography. IEEE Journal of Selected Topics in Quantum Electronics 2007;13:1641–5.16. Fried N.M., Lagoda G.A., Scott N.J. et al. Laser stimulation of the cavernous nerves in the rat prostate, in vivo: Optimization of wavelength, pulse energy, and pulse repetition rate. Engineering in Medicine and Biology Society, 2008. EMBS 2008. 30th Ann IntConference of the IEEE Aug 2008; p. 2777–80.Fried N.M., Lagoda G.A., Scott N.J. et al. Laser stimulation of the cavernous nerves in the rat prostate, in vivo: Optimization of wavelength, pulse energy, and pulse repetition rate. Engineering in Medicine and Biology Society, 2008. EMBS 2008. 30th Ann IntConference of the IEEE Aug 2008; p. 2777–80.17. Nandipati K.C., Raina R., Agarwal A., Zippe C.D. Erectile dysfunction following radical retropubic prostatectomy: epidemiology, pathophysiology and pharmacological management. Drugs & Aging. 2006;23(2):101−17.Nandipati K.C., Raina R., Agarwal A., Zippe C.D. Erectile dysfunction following radical retropubic prostatectomy: epidemiology, pathophysiology and pharmacological management. Drugs & Aging. 2006;23(2):101−17.18. Marcelo A.O., Rafael F.C., Sanket C. et al. Erectile dysfunction after robot-assisted radical prostatectomy. Expert Rev Anticancer Ther 2010;10(5):747−54.Marcelo A.O., Rafael F.C., Sanket C. et al. Erectile dysfunction after robot-assisted radical prostatectomy. Expert Rev Anticancer Ther 2010;10(5):747−54.19. Leventis A.K., Shariat S.F., Utsunomiya T., Slawin K.M. Characteristics of normal prostate vascular anatomy as displayed by power Doppler. Prostate 2001; 46:281–8.Leventis A.K., Shariat S.F., Utsunomiya T., Slawin K.M. Characteristics of normal prostate vascular anatomy as displayed by power Doppler. Prostate 2001; 46:281–8.20. Ukimura O., Gill I.S., Desai M.M. et al. Real-time transrectal ultrasonograthy during laparoscopic radical prostatectomy. J Urol 2004;172: 112–8.Ukimura O., Gill I.S., Desai M.M. et al. Real-time transrectal ultrasonograthy during laparoscopic radical prostatectomy. J Urol 2004;172: 112–8.21. Han M. Ultrasound-guided navigation in robot-assisted laparoscopic radical prostatectomy. Johns Hopkins University. Interventional Study. ClinicalTrials.gov identifier: NCT00956904 http://clinicaltrials.gov/ct2/show/study/NCT00956904Han M. Ultrasound-guided navigation in robot-assisted laparoscopic radical prostatectomy. Johns Hopkins University. Interventional Study. ClinicalTrials.gov identifier: NCT00956904 http://clinicaltrials.gov/ct2/show/study/NCT0095690422. Коган М.И., Белоусов И.И., Болоцков А.С. Артериальный кровоток в простате при синдроме хронической тазовой боли/хроническом простатите. Урология 2011;(3):22−8.Коган М.И., Белоусов И.И., Болоцков А.С. Артериальный кровоток в простате при синдроме хронической тазовой боли/хроническом простатите. Урология 2011;(3):22−8.23. Davila H.H., Mamcarz M., Nadelhaft I. et al. Visualization of the neurovascular bundles and major pelvic ganglion with fluorescent tracers after penile injection in the rat. BJU Int 2007;101:1048−51.Davila H.H., Mamcarz M., Nadelhaft I. et al. Visualization of the neurovascular bundles and major pelvic ganglion with fluorescent tracers after penile injection in the rat. BJU Int 2007;101:1048−51.24. Boyette L.B., Reardon M.A., Mirelman A.J. et al. Fiberoptic imaging of cavernous nerves in vivo. J Urol 2007; 178:2694−700.Boyette L.B., Reardon M.A., Mirelman A.J. et al. Fiberoptic imaging of cavernous nerves in vivo. J Urol 2007; 178:2694−700.25. Rais-Bahrami S., Levinson A.W., Fried N.M. et al. Optical coherence tomography of cavernous nerves: a step toward real-time intraoperative imaging during nerve-sparing radical prostat ectomy. Urology 2008; 72(1):198–204.Rais-Bahrami S., Levinson A.W., Fried N.M. et al. Optical coherence tomography of cavernous nerves: a step toward real-time intraoperative imaging during nerve-sparing radical prostat ectomy. Urology 2008; 72(1):198–204.26. Fried N.M., Rais-Bahrami S., Lagoda G.A. et al. Imaging the cavernous nerves in the rat prostate using optical coherence tomography. Lasers in Surgery and Medicine 2006;39:36–41.Fried N.M., Rais-Bahrami S., Lagoda G.A. et al. Imaging the cavernous nerves in the rat prostate using optical coherence tomography. Lasers in Surgery and Medicine 2006;39:36–41.27. Aron M., Chung B.E. et al. Preliminary experience with the Niris™ optical coherence tomography system during laparoscopic and robotic prostatectomy. J Endourol 2007;21(8):814−8.Aron M., Chung B.E. et al. Preliminary experience with the Niris™ optical coherence tomography system during laparoscopic and robotic prostatectomy. J Endourol 2007;21(8):814−8.28. Gelikonov V.M., Gelikonov G.V. New approach to cross-polarized optical coherence tomography based on orthogonal arbitrarily polarized modes. Laser Physics Letters 2006; 3(9):445−51.Gelikonov V.M., Gelikonov G.V. New approach to cross-polarized optical coherence tomography based on orthogonal arbitrarily polarized modes. Laser Physics Letters 2006; 3(9):445−51.29. Ледяев Д.С., Атдуев В.А., Загайнова Е.В. и др. Интраоперационная визуализация кавернозного нерва с использованием оптической когерентной томографии. Предварительные результаты. Медицинский альманах. Спецвыпуск. II Международная научно-практическая конференция хирургов и урологов. Тезисы. Май 2008; с. 210−2.Ледяев Д.С., Атдуев В.А., Загайнова Е.В. и др. Интраоперационная визуализация кавернозного нерва с использованием оптической когерентной томографии. Предварительные результаты. Медицинский альманах. Спецвыпуск. II Международная научно-практическая конференция хирургов и урологов. Тезисы. Май 2008; с. 210−2.30. Атдуев В.А., Загайнова Е.В., Ледяев Д.С. и др. Интраоперационная визуализация элементов нервно-сосудистого пучка при радикальной цистэктомии и радикальной простатэктомии. Патент РФ № 2375962 Бюллетень: Изобретения. Полезные модели 2009; 35 (II ч.); c. 492.Атдуев В.А., Загайнова Е.В., Ледяев Д.С. и др. Интраоперационная визуализация элементов нервно-сосудистого пучка при радикальной цистэктомии и радикальной простатэктомии. Патент РФ № 2375962 Бюллетень: Изобретения. Полезные модели 2009; 35 (II ч.); c. 492.31. Masaki F., Isao T., Riko K. et al. Cavernous nerve graft reconstruction using an autologous nerve guide to restore potency. BJU Int|2007;100: 1107–9.Masaki F., Isao T., Riko K. et al. Cavernous nerve graft reconstruction using an autologous nerve guide to restore potency. BJU Int|2007;100: 1107–9.32. Mancuso P., Rashid P. Nerve grafting at the time of radical prostatectomy: Should We Be Doing It? J Surg 2008;78:859–63.Mancuso P., Rashid P. Nerve grafting at the time of radical prostatectomy: Should We Be Doing It? J Surg 2008;78:859–63.33. Turkof E., Wulkersdorfer B., Bukaty A. Reconstruction of cavernous nerves by nerve grafts to restore potency: contemporary review of technical principles and basic anatomy. Curr Opin Urol 2006;16:401−6.Turkof E., Wulkersdorfer B., Bukaty A. Reconstruction of cavernous nerves by nerve grafts to restore potency: contemporary review of technical principles and basic anatomy. Curr Opin Urol 2006;16:401−6.34. Kim E.D., Scardino P.T., Hampel O. et al. Interposition of sural nerve restores function of cavernous nerves resected during radical prostatectomy. J Urol 1999;161:188−92.Kim E.D., Scardino P.T., Hampel O. et al. Interposition of sural nerve restores function of cavernous nerves resected during radical prostatectomy. J Urol 1999;161:188−92.35. Mikio S., Hiroyuki T. Yoshiyuki K. Health-related quality of life evaluation in patients undergoing cavernous nerve reconstruction during radical prostatectomy. Japan J Clin Oncol 2009 39(10):671−6.Mikio S., Hiroyuki T. Yoshiyuki K. Health-related quality of life evaluation in patients undergoing cavernous nerve reconstruction during radical prostatectomy. Japan J Clin Oncol 2009 39(10):671−6.