[Potency-sparing radical perineal prostatectomy].
We evaluated the results of a unilateral nerve-sparing radical perineal prostatectomy in a prospective study. Thirty patients with histologically confirmed unilateral prostate cancer and adequate erectile function preoperatively underwent a nerve-sparing procedure. The criteria were a PSA of <10 ng/ml, prostate volume of <60 ml, and a Gleason score <7. In 29 patients the procedure was technically feasible. In one patient significant damage to the neurovascular bundle was seen at the end of the procedure. Bilateral tumors were present in 18 patients on final pathology. Positive surgical margins were observed in five patients (pT2: 2/20; pT3: 3/10). After a follow-up of 3-12 months, 15 of 29 patients (51%) reported some erectile function without additional medication. Of 14 patients, 2 had enough rigidity for penetration within 3 months.The short-term results after unilateral nerve-sparing perineal prostatectomy are encouraging. Since the neurovascular bundle can be exposed very well, interposition of sural nerve should be considered.
Jakse
G
G
Urologische Klinik, Universitätsklinikum, Rheinisch-Westfälische Technische Universität, Aachen. gjakse@post.klinikum.rwth-aachen.de
Brehmer
B
B
Borchers
H
H
Verger-Kuhnke
A
A
Biesterfeld
S
S
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D007172:Erectile Dysfunction / Q000209:etiology / Q000517:prevention & control*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010413:Penis / Q000098:blood supply / Q000294:innervation; D010502:Perineum / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome