title: Impact of unilateral sural nerve graft on recovery of potency and continence following radical prostatectomy: 3-year longitudinal study.
abstract: OBJECTIVE
  We conducted a 3-year longitudinal study assessing the impact of unilateral sural nerve graft on recovery of potency and continence following radical prostatectomy.
  
  
  METHODS
  A total of 113 patients undergoing radical retropubic prostatectomy were classified into 3 groups according to the degree of nerve sparing, that is unilateral nerve preservation with contralateral sural nerve graft interposition, bilateral nerve sparing and unilateral nerve sparing. Urinary continence and potency were estimated by the UCLA Prostate Cancer Index questionnaire.
  
  
  RESULTS
  Patients in the nerve sparing plus sural nerve graft group were younger than those in the bilateral nerve sparing or unilateral nerve sparing groups. At baseline the unilateral nerve sparing plus sural nerve graft group and the bilateral nerve sparing group reported better sexual function than the unilateral nerve sparing group (62.1 and 61.5 vs 49.9, p<0.05). The bilateral nerve sparing group showed more rapid recovery than the unilateral nerve sparing plus sural nerve graft group after radical retropubic prostatectomy (p<0.01). After 24 months there were no significant differences observed between the bilateral nerve sparing and the unilateral nerve sparing plus sural nerve graft group (28.7 vs 32.9). The bilateral nerve sparing group reported a better sexual function score than the unilateral nerve sparing group throughout the postoperative period (p<0.05). The bilateral nerve sparing group maintained significantly better urinary function at 1 month after radical retropubic prostatectomy than the unilateral nerve sparing plus sural nerve graft group (p <0.05). After 3 months these groups were almost continent. The unilateral nerve sparing group reported lower urinary function scores during the first year compared to the other groups.
  
  
  CONCLUSIONS
  The nerve graft procedure may contribute to the recovery of urinary function as well as sexual function after radical retropubic prostatectomy. This finding needs to be validated in a randomized trial.
authors.affiliation: Department of Urology, Tohoku University Graduate School of Medicine, Tohoku, Japan. namikin@uro.med.tohoku.ac.jp
authors.forename: Shunichi
authors.initials: S
authors.lastname: Namiki
authors.forename: Seiichi
authors.initials: S
authors.lastname: Saito
authors.forename: Haruo
authors.initials: H
authors.lastname: Nakagawa
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: D000368:Aged; D007172:Erectile Dysfunction / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery; D011788:Quality of Life; D020127:Recovery of Function; D013497:Sural Nerve / Q000637:transplantation*; D014549:Urinary Incontinence / Q000601:surgery*