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目的:探讨保护耻骨前列腺韧带和保护尿道膜部括约肌群在耻骨后前列腺癌根治术后减少尿失禁的作用。方法:Ⅰ组32例前列腺癌按常规操作行耻骨后前列腺癌根治术,Ⅱ组32例前列腺癌采用保留耻骨前列腺韧带和尿道膜部括约肌群的方法行耻骨后前列腺癌根治术,术后1、3、6、12个月分别随访尿失禁情况。结果:两组年龄和PSA无显著差异,两组前列腺尖端切缘均无肿瘤残留,前列腺侧缘阳性率类似。Ⅱ组术后1、3、6个月尿控效果明显优于Ⅰ组(P<0.05),但1年随访,Ⅰ组和Ⅱ组尿控效果类似。结论:在耻骨后前列腺癌根治术中保留耻骨前列腺韧带作用和尿道膜部括约肌群有显著提高近期尿控的效果,但1年随访两组尿控率无明显差异。
Objective: To investigate the effect of protecting the pubic prostate ligament and protecting the urethral membranous sphincter group from reducing urinary incontinence after radical prostatectomy. Methods: Thirty-two cases of prostate cancer underwent radical prostatectomy in 32 cases of prostate cancer. Group Ⅱ, 32 cases of prostate cancer underwent radical retropubic prostatectomy with preservation of the pubic prostate ligament and urethral membrane sphincter group. After operation, Urine incontinence was followed up at 3, 6 and 12 months respectively. Results: There was no significant difference between the two groups in age and PSA. There was no tumor residue in the apical resection margin of the two groups, and the positive rate of the lateral margin of the prostate was similar. The urinary control effects in group Ⅱ were significantly better than those in group Ⅰ (control group) at 1, 3, and 6 months after operation (P <0.05). CONCLUSION: The preservation of puborectal ligament during radical prostatectomy and the sphincter of urethra membranous membrane significantly improve the effectiveness of recent urinary control. However, there was no significant difference in urinary control rates between the two groups at 1-year follow-up.