耻骨前列腺和耻骨韧带在尿失禁中的作用:一项系统综述。

IF 1.2 4区 医学 Q3 ANATOMY & MORPHOLOGY
Sabrina Costantini, Yuvedha Senthil, Michael J Montalbano, Marios Loukas
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引用次数: 0

摘要

耻骨前列腺韧带(PPL)和耻骨膀胱韧带(PVL)是支撑尿道和膀胱颈维持尿失禁的重要解剖结构。尽管这些韧带具有良好的功能,但在外科手术中,特别是根治性前列腺切除术中保留或重建这些韧带对尿失禁结果的影响仍未得到充分探讨。本系统综述综合了目前关于PPL和PVL的解剖、功能和临床意义的证据。我们按照PRISMA指南在PubMed上进行了全面的文献检索,选择了与这些韧带的解剖特征、功能作用和临床管理相关的研究。解剖研究一致强调了PPL和PVL的结构复杂性及其在维持尿道和膀胱颈部定位方面的支持作用,这对尿失禁至关重要。另一方面,功能研究进一步解释了它们参与尿道关闭过程,而临床证据表明,在根治性前列腺切除术中保留或重建这些韧带可显著改善早期和长期的尿失禁结果,这表明保留这些韧带对增强术后尿失禁恢复至关重要。研究结果强调了这些韧带在控制机制中的重要性,并提倡在未来的外科创新中考虑它们。需要进一步的研究来改进手术技术,并更好地了解这些韧带的生物力学特性,以优化患者的治疗结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The role of puboprostatic and pubovesical ligaments in urinary incontinence: a systematic review.

The puboprostatic ligament (PPL) and pubovesical ligament (PVL) are critical anatomical structures that play a significant role in maintaining urinary continence by supporting the urethra and bladder neck. Despite their well-documented functions, the impact of preserving or reconstructing these ligaments during surgical procedures, particularly radical prostatectomy, on continence outcomes remains underexplored. This systematic review synthesizes current evidence on the anatomy, function, and clinical implications of the PPL and PVL. A comprehensive literature search was conducted in PubMed following PRISMA guidelines, selecting studies related to the anatomical characteristics, functional roles, and clinical management of these ligaments. Anatomical studies consistently highlight the structural complexity and supportive roles of the PPL and PVL in maintaining urethral and bladder neck positioning, which are essential for continence. Functional studies on the other hand further explain their involvement in the urethral closure process while clinical evidence demonstrates that sparing or reconstructing these ligaments during radical prostatectomy significantly improves both early and long-term continence outcomes, suggesting that their preservation is crucial for enhancing postoperative continence recovery. The findings emphasize the importance of these ligaments in continence mechanisms and advocate for their consideration in future surgical innovations. Further research is needed to refine surgical techniques and to better understand the biomechanical properties of these ligaments to optimize patient outcomes.

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来源期刊
Folia morphologica
Folia morphologica ANATOMY & MORPHOLOGY-
CiteScore
2.40
自引率
0.00%
发文量
218
审稿时长
6-12 weeks
期刊介绍: "Folia Morphologica" is an official journal of the Polish Anatomical Society (a Constituent Member of European Federation for Experimental Morphology - EFEM). It contains original articles and reviews on morphology in the broadest sense (descriptive, experimental, and methodological). Papers dealing with practical application of morphological research to clinical problems may also be considered. Full-length papers as well as short research notes can be submitted. Descriptive papers dealing with non-mammals, cannot be accepted for publication with some exception.
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