tailieunhanh - Manual Endourology - part 7

Các tuyến tiền liệt cơ vòng phức tạp - thường được gọi là cơ vòng bên ngoài - là một mốc quan trọng trong chẩn đoán và phẫu thuật endourological. Nó là vô cùng quan trọng cho việc bảo tồn tiết dục sau khi phẫu thuật endourological. Tur-P và urethrotomy là phổ biến nhất các thủ tục | 70 Chapter 7 Transurethral Resection of Bladder Tumours O Fig. A B. Extravesical wall infiltrating inflammatory lesions Crohn s disease O Fig. 7 .24. TURB complication. Extraperitoneal perforation of the bladder wall due to N. obturatorius reflex. Note fat shines through 8 Surgical Anatomy of the Prostate Sphincter Complex Lutz Trojan Maurice-Stephan Michel Introduction - 72 Anatomy - 72 Innervation - 74 Identification - 75 Injury of the Prostate Sphincter Complex - 75 References - 75 72 Chapter 8 Surgical Anatomy of the Prostate Sphincter Complex Introduction Anatomy The prostate sphincter complex - usually referred to as the external sphincter - is an important landmark in endourological diagnostics and surgery. It is of utmost importance for the preservation of continence after endourological surgery. TUR-P and urethrotomy are the most common endourological procedures where the external sphincter and its anatomy have to be considered and preserved. The knowledge on the anatomy of the external sphincter has increased over the years. The image of a plane muscular layer distal to the prostate as often described in textbooks on pelvic anatomy is not correct o Fig. . The prostate sphincter complex consists of different muscular aspects The striated sphincter itself which is the relevant part of the complex in endourologi-cal surgery. It has an omega-like shape Q with the open side pointing towards the rectum illustrated in o Fig. . The striated sphincter is a broad muscular loop on its ventral parts with an extension over the ventral aspects of the prostate 1 2 o Figs. c . Heterogenous prostate shapes 2 . donut vs. croissant shape result in diffe- o Fig. . Incorrect image of the external sphincter. The sphincter is often described as a muscular disc distal to the .