title: Impact of unilateral interposition sural nerve graft on the recovery of sexual function after radical prostatectomy in Japanese men: a preliminary study.
abstract: OBJECTIVE
  To determine the effect of an interposition nerve graft on sexual function after radical prostatectomy.
  
  
  METHODS
  This study includes 64 patients, without hormonal therapy, who underwent a radical prostatectomy and intraoperative electrophysiological confirmation of cavernous nerve preservation. Twelve patients underwent a unilateral interposition sural nerve graft (UNG) for the resected neurovascular bundle. Twenty-one and 31 patients underwent bilateral nerve-sparing (BNS) and unilateral nerve-sparing (UNS) surgery without a nerve graft, respectively. As the age of patients was significantly younger in the UNG group than in the other groups, age-matched analysis also was conducted. Sexual function, evaluated by a self-administered questionnaire using the University of California Los Angeles-Prostate Cancer Index, was compared statistically among the three groups.
  
  
  RESULTS
  In the age-matched analysis, the postoperative sexual function (SXF) score of the UNG group showed an intermediate level of recovery between those of the BNS and UNS groups at 12 months and reached the same level as the score at 12 months of the BNS group at 18 months postoperatively. The difference in the SXF score between the UNG and UNS groups began to appear after 6 months postoperatively and increased steadily with time. However, the background factors, such as the baseline SXF score, the usage rate of phosphodiesterase 5 inhibitors, and the rate of comorbidities were different between the UNG and UNS groups.
  
  
  CONCLUSIONS
  The difference of the SXF score between the UNG and UNS groups increased with time after 6 months postoperatively. However, it might be difficult at present to attribute a better recovery of the SXF score to the nerve graft because of the difference in the background factors between the groups.
authors.affiliation: Department of Urology, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Saito
authors.forename: Shunichi
authors.initials: S
authors.lastname: Namiki
authors.forename: Kenji
authors.initials: K
authors.lastname: Numahata
authors.forename: Makoto
authors.initials: M
authors.lastname: Satoh
authors.forename: Shigeto
authors.initials: S
authors.lastname: Ishidoya
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ito
authors.forename: Haruo
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kaiho
authors.forename: Takehiko
authors.initials: T
authors.lastname: Sanada
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yamada
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Arai
mesh_terms: D006801:Humans; D007564:Japan; D008297:Male; D010410:Penile Erection; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D020127:Recovery of Function; D019529:Sexuality / Q000502:physiology*; D013497:Sural Nerve