METHOD OF SURGICAL TREATMENT OF ERECTILE DYSFUNCTION IN PATIENTS AFTER RADICAL PROSTATECTOMY Russian patent published in 2021 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to urology. Two-sided selection of n.suralis and bilateral incision within n.femoralis and inguinal ligament are performed, as well as a double-sided incision in the region near the base of the penis. An epineural window is then formed by means of a microscope, in which a perineural opening is formed and through the formed epineural and perineural opening on the lateral surface of the main stem of n.femoralis selective axonotomy of neural bundles occurring in n.femoralis is performed. Further, the proximal end of the separated n.suralis with n.femoralis is connected by an anastomosis of the side-to-end type, using a non-absorbable suture material, then the distal end of n.suralis is subcutaneously in the incision at the base of the penis, with further formation of anastomosis between n.suralis and cavernous penile body. That is followed by 1 cm incision on the dorsal surface of the base of the penis, after which a distal portion of n.suralis is inserted through the incision by bulging probe into cavernous body in direction of penis head, wherein all above actions, starting with attachment of proximal end of n.suralis to n.femoralis, is repeated from opposite side. After epineural and perineural windows are formed on lateral surface of n.femoralis main stem, selective axonectomy of nerve bundles innervating m.vastus lateralis is additionally performed, with formation of diastasis between intersected proximal and distal neural bundles. Further, the intersected proximal nerve fibers are combined in the n.femoralis composition with the proximal nerve fibers in the isolated n.suralis by endoneuroal-perineal nodular sutures. For endoneuroal-perineural nodal sutures, a non-absorbable sutures material of prolen with size of 11-0 - 12-0 and supermicroosurgical instruments, after said stages additional microsurgical fixation of n.femoralis with n.suralis is performed with the help of second line of epineurial-perineural nodular sutures with suturing 8-0 - 9-0, wherein all the above steps are performed under an operating microscope. After n.suralis introduction with the help of bulbous probe into cavernous bodies, additional microsurgical fixation of n.suralis epineural cover is performed with albino cavernosa of cavernous bodies with the help of interrupted sutures 8-0 is sutured with filament, besides, all above mentioned actions, starting from moment of n.femoralis extraction, are repeated from the opposite side.

EFFECT: method enables higher efficiency of restoration of innervations of penis corpuscles.

1 cl, 2 ex