| Abstract: |
While cavernous nerve preservation is ideal for optimal recovery of erectile function after radical prostatectomy, unilateral or bilateral nerve resection may be necessary in a given individual at increased risk for extracapsular extension in order to achieve a negative surgical margin. In such patients cavernous nerve grafting with autogenous sural or genitofemoral nerve may improve recovery of erectile function. While pilot studies demonstrated efficacy in over 40% of men undergoing bilateral nerve grafting, more recent data have been more sobering with only 11% of men undergoing bilateral nerve grafting able to consistently obtain adequate erections. A randomized trial of unilateral nerve grafting has demonstrated no significant improvement in potency with unilateral sural nerve grafting. Ultimately, a randomized trial of bilateral nerve grafting will be necessary to determine its role in the management of men needing bilateral nerve resection at the time of radical prostatectomy. |
