Riassunto
L’intervento di prostatectomia radicale con tecnica nerve-sparing assicura un buon controllo a lungo termine del carcinoma prostatico in pazienti con malattia locoregionale [1]. La disfunzione erettile rappresenta una delle complicanze più frequenti dopo l’intervento chirurgico e il recupero della funzionalità è direttamente correlabile con il grado di integrità anatomica del fascio neurovascolare periprostatico (FNVP) [1]. Recenti studi sono stati incentrati sulla valutazione preoperatoria di questa struttura per un corretto planning terapeutico e alcuni autori affermano che un completo studio morfologico del FNVP prima dell’intervento — considerata la notevole variabilità individuale del suo percorso anatomico — riduce significativamente la percentuale di lesioni iatrogene da resezione accidentale [2, 3]. Non da ultimo, le teorie più recenti hanno introdotto il concetto di “neurapraxia”, che letteralmente comprende il fallimento della conduzione dello stimolo nervoso, senza evidenti cambiamenti morfologici, dovuto a lesioni da compressione, stiramento o ischemia, che sarebbero responsabili del ritardo nel recupero della funzionalità erettile postoperatoria [4, 5].
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Panebianco, V., Osimani, M., Gentile, V. (2010). Valutazione RM del fascio neurovascolare e grado di deficit funzionale nel paziente prostatectomizzato. In: Passariello, R., Panebianco, V., Di Silverio, F., Sciarra, A. (eds) Imaging RM della prostata. Springer, Milano. https://doi.org/10.1007/978-88-470-1516-6_22
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DOI: https://doi.org/10.1007/978-88-470-1516-6_22
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