Nerve-sparing techniques in open and laparoscopic prostatectomy.
Open and laparoscopic radical prostatectomy is a safe and effective treatment for organ-confined prostate cancer with excellent cancer control and quality of life outcomes. We present current nerve-sparing techniques used in open, laparoscopic and robot-assisted prostatectomy to maximize postoperative potency. We review the literature and describe important anatomical landmarks and technical aspects that differentiate between approaches. Nerve trauma is inherent to the surgery and cannot be completely avoided. These techniques serve to minimize injury without compromising oncologic outcomes. In combination with postoperative pharmacological and mechanical recuperative approaches, nerve-sparing surgery has made an impact in postprostatectomy quality of life.
Rodriguez
Esequiel
E
University of California Irvine Medical Center, Assistant Professor, Department of Urology, Orange, CA, USA. erodrigu@uci.edu
Melamud
Ori
O
Ahlering
Thomas E
TE
D007172:Erectile Dysfunction / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D059348:Peripheral Nerve Injuries; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011467:Prostate / Q000098:blood supply / Q000294:innervation* / Q000473:pathology / Q000601:surgery; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011788:Quality of Life; D012371:Robotics