الفهرس | Only 14 pages are availabe for public view |
Abstract One of the major and disconcerting complication of prostatectomy is impotence but the cause of impotence among men undergoing surgical prostatectomy or transurethral resection of the prostate (TURP) is still controversial. This study included 100 potent patients who presented to Urology Department, Benha Faculty of Medicine with symptoms of benign prostatic hyperplasia. They were divided into two groups according to management: 50 patients underwent TURP group (1) and 50 patients underwent transvesical open prostatectomy group (II). By usmg of SPACE device (single potential analysis of cavernous electrical activity) as a non invasive method for diagnosis of cavernous autonomic dysfunction after TURP and transvesical open prostatectomy first, second and third month postoperatively. Only four patients (8%) out of 50 patients, become totally impotent 3 months after TURP which gave abnormal response of SPACE pattern in the form of decrease amplitude less than 100 uv and no synchronization of spike in both cavernous bodies. Summary & conclusion 81 On the other hand 92% (46 patients) were given normal response of SPACE in the form of increase the amplitude of potentials 250-500 uv and synchronization of spikes in both cavernous bodies by follow up the patients first, second and third month after TURP. However, in case of transvesical open prostatectomy, no change of potency by SPACE pattern which gave normal response in the first, second and third month postoperatively. Conclusion: In this study it has been found that potency is affected by TURP, 8% (4 patients) became totally impotent 3 months postoperatively. • The following factors are incriminated; the smaller size of the prostate the more is the transmission of heat during cutting and cauterization, secondly excessive cauterization especially at the apex of the prostate and resection down to the capsule. The heat generated due to these factors do affect the cavernous nerves. Also, it has been found that perforation of the capsule with subsequent extravasation do affect potency due to injury and fibrosis of the cavernous nerves. On the other hand, there was no effect on potency after transvesical open prostatectomy by follow up of the patients first, second and third months postoperatively. |