Morphological aspects of recovery of the pelvic fascial structures for prevention of the incontinence after radical prostatectomy
Aim. To study tissue features of fascial pelvic structures and to substantiate the possibility of the formation of a posterior suspension of urethrovesical anastomosis with persistent fascial structures of the pelvis in patients after prostatectomy. Materials and methods. An in vivo morphological analysis of the pelvic fascial structures was carried out in 10 men of different ages and body types: endopelvic fascia, Denonville fascia, visceral bladder fascia. The material for the study was 30 histological blocks of fascial structures of the small pelvis after retropubic prostatevesiculectomy. Results. It has been established that the organization of all studied fascias is based on dense, fibrous, formed connective tissue, between parallel wavy bundles of which were revealed layers of loose unformed connective tissue containing fibroblasts, fibrocytes, small and large vessels. Around the fascias were located, connected with them, accumulations of adipose tissue and loose unformed connective tissue, including bundles of collagen and elastic fibers of various thicknesses. Conclusion. Analysis of morphological characteristics revealed tissue homogeneity of the studied tissues. As a result, when the fatty tissue is removed as completely as possible and the dense, fibrous, formed connective tissue of stitched fascias comes together, a stable and continuous scar is formed after the throat pups to secure the anatomical formations with the formation of the back suspension of the urethrovesical anastomosis by keeping the fascia.