Valutazione RM del fascio neurovascolare e grado di deficit funzionale nel paziente prostatectomizzato

  • Valeria Panebianco
  • Marcello Osimani
  • Vincenzo Gentile

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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Copyright information

© Springer-Verlag Italia 2010

Authors and Affiliations

  • Valeria Panebianco
    • 1
  • Marcello Osimani
    • 1
  • Vincenzo Gentile
    • 1
  1. 1.Dipartimento di Scienze Radiologiche “Sapienza”Università di RomaRomaItalia

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