Bilateral nerve graft during radical retropubic prostatectomy: 1-year followup Journal Article

Authors: Kim, E. D.; Nath, R.; Kadmon, D.; Lipshultz, L. I.; Miles, B. J.; Slawin, K. M.; Tang, H. Y.; Wheeler, T.; Scardino, P. T.
Article Title: Bilateral nerve graft during radical retropubic prostatectomy: 1-year followup
Abstract: Purpose: With the interposition of a sural nerve graft to replace resected cavernous nerves at radical retropubic prostatectomy, we have previously reported the return of effective erectile function. We determine the efficacy of this procedure in a series of men with at least 1-year followup. Materials and Methods: A total of 12 patent men (mean age plus or minus standard deviation 57 +/- 6 years) with clinically localized prostate cancer underwent radical retropubic prostatectomy, with deliberate wide bilateral neurovascular bundle resection and placement of bilateral nerve grafts. A series of patient and partner erectile dysfunction questionnaires, and patient interviews were performed at 3, 6, 12 and 18 months postoperatively. Only results for those men with a followup of 12 months or greater (mean 16 +/- 4) are presented. A control group of 12 men who had undergone bilateral nerve resection but declined nerve graft placement, was also followed. Results: Of the 12 men 4 (33%) had spontaneous medically unassisted erections sufficient for sexual intercourse with vaginal penetration. An additional 5 (42%) men describe "40 to 60%" spontaneous erections, with fullness, no rigidity and not able to penetrate. Overall, 9 (75%) men had return of erectile activity. No demonstrable erections occurred before 5 months postoperatively. The greatest return of function was observed at 14 to 18 months after surgery. Conclusions: This surgical technique has minimal morbidity and represents a significant advance in prostate cancer surgery in men requiring bilateral nerve resection. Our study clearly demonstrates recovery of erectile function in men who underwent bilateral nerve graft placement during radical retropubic prostatectomy when both cavernous nerves were deliberately resected.
Keywords: follow-up studies; transplantation; prostatectomy; sexual function; penile erection; erectile function; recovery; dysfunction; transplants; cavernous nerves; cancer; parasympathetic reinnervation
Journal Title: Journal of Urology
Volume: 165
Issue: 6 Pt. 1
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2001-06-01
Start Page: 1950
End Page: 1956
Language: English
ACCESSION: WOS:000168623400028
DOI: 10.1016/s0022-5347(05)66248-9
PUBMED: 11371887
Notes: Article -- Source: Wos
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  1. Peter T Scardino
    621 Scardino