title: Is residual neurovascular tissue on prostatectomy specimens associated with surgeon intent at nerve-sparing and postoperative quality of life measures?
abstract: OBJECTIVE
  Preservation of periprostatic neurovascular tissue at the time of radical prostatectomy has been correlated with subsequent erectile function and urinary continence. We evaluated whether the amount of neurovascular tissue identified on prostatectomy specimens correlated with surgeon's intention of nerve-sparing and/or predicted quality of life outcomes.
  
  
  METHODS
  Radical prostatectomy specimens from 60 patients were evaluated by 2 pathologists for residual neurovascular bundle tissue. Reviewable pathology was available for 17, 19, and 19 patients with bilateral, unilateral, and non-nerve-sparing radical prostatectomy, respectively. The patients completed the Expanded Prostate Cancer Index Composite, a validated quality of life questionnaire. Differences between neurovascular tissue thickness, surgeon's intent at nerve-sparing, and quality of life among patients in each group were analyzed using standard statistical software.
  
  
  RESULTS
  Neurovascular tissue thickness identified on radical prostatectomy specimens did not correlate with surgeon's intent at performing a nerve-sparing procedure, nor was it found to be predictive of postoperative quality of life. Surgeon's intent at neurovascular preservation, however, was associated with improved sexual and urinary function scores at 1 year (both P < 0.05).
  
  
  CONCLUSIONS
  Surgeon intent, regardless of the amount of neurovascular tissue identified on radical prostatectomy specimen, is predictive of postoperative sexual-related and urinary quality of life. This suggests that factors other than the amount of neurovascular tissue spared contribute to postoperative sexual and urinary function.
authors.affiliation: Department of Urology, Ann Arbor, MI 48109, USA.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Bradford
authors.forename: Alon Z
authors.initials: AZ
authors.lastname: Weizer
authors.forename: Scott M
authors.initials: SM
authors.lastname: Gilbert
authors.forename: Rodney L
authors.initials: RL
authors.lastname: Dunn
authors.forename: Kirk
authors.initials: K
authors.lastname: Wojno
authors.forename: Rajal
authors.initials: R
authors.lastname: Shah
authors.forename: David P
authors.initials: DP
authors.lastname: Wood
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000098:blood supply / Q000294:innervation; D011468:Prostatectomy / Q000379:methods* / Q000523:psychology; D011471:Prostatic Neoplasms / Q000523:psychology / Q000601:surgery*; D011788:Quality of Life