title: Neuroanatomic basis for traction-free preservation of the neural hammock during athermal robotic radical prostatectomy.
abstract: OBJECTIVE
  Much of the progress achieved in the past two decades in improving potency outcomes after radical prostatectomy has resulted from an improved appreciation of the anatomic basis of the nerves responsible for erection. We review the current literature evaluating the neuroanatomy of prostate and operative strategies for better preservation of sexual function.
  
  
  RESULTS
  Recent studies suggest an alternative and more complex course of nerves than previously described. Periprostatic nerves can be divided into three broad surgically identifiable zones: the proximal neurovascular plate, the predominant neurovascular bundle, and the accessory neural pathways. Better appreciation of the variable and often invisible anatomical course of the cavernosal nerves continues to engender innovations in surgical technique to optimize their preservation.
  
  
  CONCLUSIONS
  Improved anatomic understanding has optimized surgical technique in order to improve potency outcomes following radical prostatectomy.
authors.affiliation: Lefrak Center of Robotic Surgery, James Buchanan Brady Foundation, Department of Urology, Weill Medical College of Cornell University, New York Presbyterian Hospital, USA.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Srivastava
authors.forename: Sonal
authors.initials: S
authors.lastname: Grover
authors.forename: Prasanna
authors.initials: P
authors.lastname: Sooriakumaran
authors.forename: Gerald
authors.initials: G
authors.lastname: Tan
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takenaka
authors.forename: Ashutosh K
authors.initials: AK
authors.lastname: Tewari
mesh_terms: D007172:Erectile Dysfunction / Q000453:epidemiology; D006801:Humans; D008297:Male; D010410:Penile Erection / Q000502:physiology; D011467:Prostate / Q000294:innervation*; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012307:Risk Factors; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome