Abstract: Objective To investigate the value of preserving urethral length and nerve vessels in radical resection of T1 prostate cancer.
Methods Patients with stage T1 prostate cancer admitted to our hospital were divided into two groups:group A(53 cases) and group B(57 cases)Routine laparoscopic surgery was performed in group A,while vascular and nerve bundles were preserved in group B,and urethral length was preserved to the maximum extent.Perioperative indexes,urodynamic indexes,urinary control ability and BMSFI scores were compared between the two groups.
Results The amount of bleeding and postoperative time of getting out of bed in group B[(156.52±12.56)ml and (42.82±6.21)h] were shorter than that in group A[(184.93±10.04)ml and (49.19±7.84)h](P<0.05).The postoperative bladder compliance,maximum urethral pressure,maximum urinary flow,maximum detrusor pressure and urinary control ability of group B[(32.31±3.02)cmH2O、(40.09±2.46)cm H2O、(11.65±1.58)ml/s、(17.26±1.85)cm H2O] were all superior to group A[(27.93±2.35)cm H2O、(37.29±2.24)cm H2O、(9.29±0.64)ml/s、(13.16±1.10)cm H2O](P<0.05).In group B, the proportion of grade 0 was 52.63% six months after operation, which was higher than that one month after operation（29.82%） and group A（39.62%）(P<0.05).Intra-group comparison after operation in group B,Sexual desire, erectile function, ejaculation function, problem assessment, overall satisfaction rating[(3.26±0.42),(8.79±1.01),(5.43±0.76),(8.79±0.94),(1.89±0.23)] were significantly lower than before surgery[(3.86±0.73),(9.51±2.01),(6.23±0.85),(9.29±1.41),(2.28±0.29)].However, the inter-group comparison was significantly higher than that of group A after surgery[(3.08±0.47),(8.43±0.74),(5.07±0.59),(8.34±0.45),(1.74±0.21)],the difference was statistically significant(P<0.05).
Conclusion Preserving the length of vascular nerve bundle and urethra during surgery can reduce intraoperative blood loss, get out of bed as soon as possible after surgery, and improve postoperative urinary control ability and sexual function.

Key words: prostate cancer, vascular bundle preservation, urethral length, urine control ability, sexual function