[Nerve repair strategies for restoration of erectile function after radical pelvic surgery].
Iatrogenic cavernous nerve lesions occurring during radical pelvic surgery often lead to irreversible erectile dysfunction. The nerve defects after excision of the neurovascular bundles must be reconstructed by interposition grafting to supply a permissive scaffold for oriented axonal regrowth. The use of autologous nerve grafts for the repair of human cavernous nerves during radical prostatectomy has been controversial regarding the limited success achieved with bilateral nerve grafting. Artificial nerve guides consisting of natural or synthetic materials have been successfully used for bridging peripheral nerve defects. The combination with Schwann cells, neurotrophic factors and extracellular matrix components has been shown to promote cavernous nerve regeneration.
May
F
F
Urologische Universitätsklinik und Poliklinik, Technische Universität München. mayflorian@aol.com
Schoeler
S
S
Vroemen
M
M
Matiasek
K
K
Apprich
M
M
Erhardt
W
W
Hartung
R
R
Gansbacher
B
B
Weidner
N
N
D007172:Erectile Dysfunction / Q000209:etiology / Q000601:surgery*; D048091:Guided Tissue Regeneration / Q000379:methods*; D006801:Humans; D008297:Male; D009416:Nerve Regeneration; D019635:Neurosurgical Procedures / Q000379:methods*; D010413:Penis / Q000294:innervation*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D020127:Recovery of Function; D012583:Schwann Cells / Q000637:transplantation*; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects*