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首页> 外文期刊>The journal of sexual medicine >Neurophysiological Testing to Assess Penile Sensory Nerve Damage After Radical Prostatectomy
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Neurophysiological Testing to Assess Penile Sensory Nerve Damage After Radical Prostatectomy

机译：评估前列腺根治术后阴茎感觉神经损伤的神经生理学测试

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Introduction. Radical prostatectomy (RP) can lead to erectile dysfunction due to surgical injury of the cavernous nerves. However, there is no simple, objective test to evaluate cavernous nerve damage caused by RP in clinical practice. Aim. To assess the value of the measurement of penile thermal and vibratory sensory thresholds to reflect cavernous nerve damage caused by RP. Methods. We included 42 consecutive patients who underwent RP with cavernous nerve sparing (laparoscopic approach, N=12) or without cavernous nerve sparing (laparoscopic, N=13; retropubic, N=11; or transperineal, N=6). Penile thermal (warm and cold) and vibratory sensory thresholds were measured twice, together with the Erectile Dysfunction Symptom Score (EDSS), 1month before and 2 months after RP. Main Outcome Measures. Penile sensory thresholds for warm, cold, and vibration sensations. Results. Penile sensory thresholds for warm (P<0.0001) and cold (P<0.0001) sensations significantly increased after non-nerve-sparing RP, but not after nerve-sparing RP. Vibration threshold only increased after transperineal non-nerve-sparing RP (P=0.031). EDSS values were significantly increased in all groups of patients 2months after surgery. Conclusions. Sensory nerve fibers carrying penile skin sensations travel with the cavernous nerves in the pelvis. Therefore, testing these sensations may help to evaluate the extent of cavernous nerve damage caused by RP. In this series, post-operative changes in penile sensory thresholds differed with the surgical technique of RP, as the cavernous nerves were preserved or not. The present results support the value of quantitative penile sensory threshold measurement to indicate RP-induced cavernous nerve injury.
机译：介绍。根治性前列腺切除术（RP）可能由于海绵状神经的手术损伤而导致勃起功能障碍。但是，在临床实践中，尚没有简单，客观的测试来评估RP引起的海绵状神经损伤。目标。评估阴茎热和振动感觉阈值的测量值，以反映RP引起的海绵状神经损伤。方法。我们纳入了42例接受RP的患者，其中RP伴有海绵状神经保留（腹腔镜方法，N = 12）或无海绵状神经保留（腹腔镜，N = 13;耻骨后，N = 11;或会阴部，N = 6）。在RP之前1个月和RP 2个月后，两次测量阴茎的热（冷和热）和振动感觉阈值，以及勃起功能障碍症状评分（EDSS）。主要观察指标。对温暖，寒冷和振动的阴茎感觉阈值。结果。非神经保留型RP后，温暖（P <0.0001）和寒冷（P <0.0001）感觉的阴茎感觉阈值显着增加，而神经保留型RP则没有。振动阈值仅在经会阴非神经保留型RP后才增加（P = 0.031）。术后2个月，所有患者组的EDSS值均显着升高。结论。带有阴茎皮肤感觉的感觉神经纤维与骨盆中的海绵状神经一起传播。因此，测试这些感觉可能有助于评估RP引起的海绵状神经损伤的程度。在该系列中，由于保留或不保留海绵状神经，因此手术后阴茎感觉阈值的变化与RP的手术技术不同。本研究结果支持定量阴茎感觉阈值测量的值，以指示RP引起的海绵状神经损伤。

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