Bilateral nerve graft during radical retropubic prostatectomy

1-Year followup

Edward Kim, R. Nath, D. Kadmon, L. I. Lipshultz, B. J. Miles, K. M. Slawin, H. Y. Tang, T. Wheeler, P. T. Scardino

Research output: Contribution to journalArticle

49 Citations (Scopus)

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 potent 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.

Original languageEnglish (US)
JournalJournal of Urology
Volume165
Issue number6 I
StatePublished - Jan 1 2001
Externally publishedYes

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Prostatectomy
Transplants
Prostatic Neoplasms
Sural Nerve
Coitus
Recovery of Function
Erectile Dysfunction
Interviews
Morbidity
Control Groups

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Kim, E., Nath, R., Kadmon, D., Lipshultz, L. I., Miles, B. J., Slawin, K. M., ... Scardino, P. T. (2001). Bilateral nerve graft during radical retropubic prostatectomy: 1-Year followup. Journal of Urology, 165(6 I).

Bilateral nerve graft during radical retropubic prostatectomy : 1-Year followup. / Kim, Edward; Nath, R.; Kadmon, D.; Lipshultz, L. I.; Miles, B. J.; Slawin, K. M.; Tang, H. Y.; Wheeler, T.; Scardino, P. T.

In: Journal of Urology, Vol. 165, No. 6 I, 01.01.2001.

Research output: Contribution to journalArticle

Kim, E, Nath, R, Kadmon, D, Lipshultz, LI, Miles, BJ, Slawin, KM, Tang, HY, Wheeler, T & Scardino, PT 2001, 'Bilateral nerve graft during radical retropubic prostatectomy: 1-Year followup', Journal of Urology, vol. 165, no. 6 I.
Kim E, Nath R, Kadmon D, Lipshultz LI, Miles BJ, Slawin KM et al. Bilateral nerve graft during radical retropubic prostatectomy: 1-Year followup. Journal of Urology. 2001 Jan 1;165(6 I).
Kim, Edward ; Nath, R. ; Kadmon, D. ; Lipshultz, L. I. ; Miles, B. J. ; Slawin, K. M. ; Tang, H. Y. ; Wheeler, T. ; Scardino, P. T. / Bilateral nerve graft during radical retropubic prostatectomy : 1-Year followup. In: Journal of Urology. 2001 ; Vol. 165, No. 6 I.
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AB - 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 potent 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.

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