Patent RU-2765404-C1 (RU)
Title: METHOD FOR PREVENTING THE DEVELOPMENT OF ERECTILE DYSFUNCTION DURING INTRATISSUAL RADIATION THERAPY OF PROSTATE CANCER WITH A HIGH DOSE RATE SOURCE Ir192
Inventor: SOLODKIJ VLADIMIR ALEKSEEVICH
IPC: A61N5/10
Filed: 2021-05-11
Granted: 2022-01-28
Abstract: FIELD: medicine.  
     SUBSTANCE: invention relates to medicine, namely oncology and urology. A clinical and instrumental examination of the patient is carried out. The stage of the disease is established, the state of erectile function, EF, is determined, the patient’s immediate desire to maintain EF and the patient’s interest in continuing sexual life after prostate cancer treatment. Brachytherapy is performed with a high-power source, for this purpose an anesthetic manual is performed. The patient is placed on the operating table on his back, the legs are fixed on the supports attached to the table in a sideways and upward position at 90° in the hip joint, the scrotum is lifted up with a Band-Aid, releasing the perineum, antiseptic treatment of the skin of the perineum, scrotum and anus is performed. A Foley catheter is inserted into the bladder and squeezed. A rectal ultrasound sensor of the device is inserted into the patient’s rectum and fixed on the stepper, with a brachy-balloon treated with gel, changing the position of the stepper and filling the brachy-balloon with saline solution, optimal visualization of the prostate gland is achieved. Then, a continuous scan of the prostate gland is carried out from the base to the tip. The obtained images are sent to the planning system, after which dosimetric planning of interstitial radiation therapy is carried out in three stages. At the first stage, information about the patient is entered into the planning program, the obtained prostate images are imported into the planning program. At the second stage, the grid position is standardized, the contours of the prostate, urethra, rectum, seminal vesicles are outlined, intrastate positions are planned and a “virtual” dosimetric plan for interstitial irradiation is drawn up. At the third stage, intrastates are inserted into the prostate gland through a real “coordinate brachy-therapeutic lattice” and continuous scanning of the organ is carried out. After that, the contours of the organs are compared, the position of the virtual intrastate is combined with a real visualized needle. At the same time, according to the parameters entered, a dosimetric plan is calculated using the program, namely, the calculated dose in the planned amount of radiation, maximum and minimum indicators for critical organs. Further, the accepted and approved irradiation plan is sent to the workstation, and the delivery tubes from the Microselectron device are attached to the intrastates introduced, and immediately before the start of the irradiation session, the location of the neurovascular bundles is determined using ultrasound examination with Doppler mapping. Further, under ultrasound control, a needle attached to a syringe with 20 ml of 0.9% saline solution is inserted laterally into the cellular space from both sides of the prostate gland through the skin of the perineum. The injection is performed with the simultaneous movement of the needle in the caudal direction until a “hydro-cushion” is formed, which pushes the neurovascular bundle laterally away from the prostate gland at a distance of up to 0.5 cm.   
     EFFECT: method reduces the time of edema in the adipose tissue of the pelvis to 15-20 minutes, which corresponds to the time of the irradiation session when performing high-dose brachytherapy.  
     3 cl, 3 dwg