Evaluation of genitofemoral nerve donor site morbidity after radical prostatectomy Journal Article
| Authors: | Kilgo, M. S.; Howard, M. A.; Kaplan, G.; Rabbani, F.; Scardino, P. T.; Cordeiro, P. G.; Ward, P.; Glickman, L. T. |
| Article Title: | Evaluation of genitofemoral nerve donor site morbidity after radical prostatectomy |
| Abstract: | Background: The sural nerve is commonly used as a donor site for cavernous nerve grafting. However, the genitofemoral nerve is accessible and easily dissected and may represent an improved donor site for this procedure. Methods: Fourteen patients underwent radical prostatectomy followed by cavernous nerve grafting using the genitofemoral nerve. Seventeen donor sites (3 patients underwent bilateral grafts) were assessed by questionnaires (including the McGill Pain Scale) and focused neurologic examination. Results: Residual numbness in the genitofemoral nerve distribution was noted in 9 of 17 donor sites (53%). No patients reported that the deficits interfered with normal daily activities. All patients denied the presence of burning, cold sensitivity, or pain. All patients scored O on each of the 3 pain rating components of the short form McGill Pain questionnaire (sensory, affective, or total). Furthermore, no patients documented pain on either the PPI or VAS portions of the questionnaire. On examination, patients were unable to discriminate between sharp versus dull stimuli in 3 donor sites (17.6%), while 7 donor sites (41.2%) showed decreased light-touch sensation. The Semmes-Weinstein testing demonstrated that 8 (47.1%) were found to have distinct areas with sensory deficit ranging in size from 23 to 63 cm 2 (mean, 16.6 cm 2). The highest-pressure thresholds for each of the 17 donor sites ranged from 3.61 to 6.45 g/mm 2 (mean, 4.91 g/mm 2). The mean pressure threshold for the control regions (n = 11) was 3.35 g/mm 2 (range, 2.38-4.71 g/mm 2, P = 0.014). Only 50% of the sensory deficits documented by the Semmes-Weinstein test were clinically apparent to the patients. Conclusions: Due to its low donor site morbidity, the genitofemoral nerve is an excellent donor source for cavernous nerve grafting during radical prostatectomy. In the majority of the patients, the sensory deficit produced by resection of this nerve is minimal and caused no other adverse symptoms. Harvest of this nerve prevents the additional morbidity associated with a donor site located elsewhere on the body (ie, sural nerve). Copyright © 2005 by Lippincott Williams & Wilkins. |
| Keywords: | adult; clinical article; controlled study; treatment outcome; aged; middle aged; paresthesia; donor site; prospective studies; pain; morbidity; prostatic neoplasms; questionnaire; thigh; pilot projects; prostatectomy; burn; pain measurement; pain assessment; cavernous nerve; neurologic examination; nerve graft; graft; nerve; femoral nerve; nerve transfer; cold sensitivity; stimulus response; genitofemoral; perceptive threshold; pressure sense |
| Journal Title: | Annals of Plastic Surgery |
| Volume: | 55 |
| Issue: | 1 |
| ISSN: | 0148-7043 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2005-01-01 |
| Start Page: | 57 |
| End Page: | 62 |
| Language: | English |
| DOI: | 10.1097/01.sap.0000168029.74274.b7 |
| PUBMED: | 15985792 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 7" - "Export Date: 24 October 2012" - "CODEN: APCSD" - "Source: Scopus" |
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