title: Cavernous nerve reconstruction during radical prostatectomy by sural nerve grafting: surgical technique in nerve harvesting and grafting.
abstract: The authors performed cavernous nerve reconstruction by nerve grafting in 22 patients (unilateral-16, bilateral-6) between August 2001 and June 2004. Harvesting of the sural nerve was unexpectedly more difficult than nerve grafting in the extremities or the head and neck, because a knee and lumbar bending position was impossible due to the pelvic surgical field. Suture of the grafted nerve on the distal side required great effort, because there was only sufficient space for one hand at the maximum in a deep region of the pelvic cavity, and the nerve ends easily become invisible by inflow of even a small amount of urine or blood. The mean time of the nerve harvesting and grafting was 1 hr 50 min for unilateral grafting and 2 hr 40 min for bilateral grafting. Recovery of erectile function was observed in about half the patients who had undergone surgery nearly 1 year before. Since harvesting of the sural nerve and nerve grafting were more difficult than expected, modification and improvement of many surgical elements, such as improvement of surgical devices and application of endoscopic techniques, are necessary.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kagawa University, Kagawa, Japan.
authors.forename: Gan
authors.initials: G
authors.lastname: Muneuchi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kuwata
authors.forename: Shigeo
authors.initials: S
authors.lastname: Taketa
authors.forename: Masashi
authors.initials: M
authors.lastname: Inui
authors.forename: Fumio
authors.initials: F
authors.lastname: Tsukuda
authors.forename: Osamu
authors.initials: O
authors.lastname: Shimada
authors.forename: Hiroharu H
authors.initials: HH
authors.lastname: Igawa
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kakehi
mesh_terms: D000368:Aged; D007172:Erectile Dysfunction / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery; D020127:Recovery of Function; D013497:Sural Nerve / Q000637:transplantation*; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome