title: Histological evaluation of nerve sparing technique in robotic assisted radical prostatectomy.
abstract: BACKGROUND
  The objective of this study is to compare intrafascial nerve-sparing (NS), interfascial NS and non-NS prostatecomy specimens to assess the feasibility of NS technique in Robot-assisted radical prostatectomies (RARP).
  
  
  METHODS
  The records of the first 43 consecutive patients (86 prostatic sides (lobe) who underwent NS RARP (6 intrafascial NS, 46 interfacial NS, 34 non-NS) were reviewed and histopathological examinations were performed. The presence and distribution of periprostatic neurovascular structures were histologically evaluated using mid-gland section of each prostate lobe in the prostatectomy specimen and it was immunostained with the S-100 antibody for quantitative analysis of nerves.
  
  
  RESULTS
  The average number of nerve fibers per prostatic half was 37.2 ± 20.6. The number of resected peri-prostatic nerves counted was 13.7 ± 13.5, 30.5 ± 15.0 and 50.4 ± 20.4 in intrafascial NS, interfascial NS and non-NS specimens, respectively. The difference in the number of nerve bundle counts in the three groups was statistically significant (P < 0.05). Patients with urinary continence at 6 months after surgery had significantly less number of nerve fibers resected with the prostate than the incontinence group (P = 0.013) and the number of nerve fibers resected in the potent group were lower than in the impotent group but did not reach statistical significance (P = 0.057).
  
  
  CONCLUSIONS
  Our study showed that NS RARP could be performed according to surgeons' intention (intrafascial, interfascial or non-NS) and urinary continence significantly correlated to the number of nerve fibers resected with the prostate.
authors.affiliation: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Kazushi
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Shigemura
authors.affiliation: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hinata
authors.affiliation: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Muramaki
authors.affiliation: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyake
authors.affiliation: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
keywords: Histological evaluation; nerve-sparing; robot-assisted radical prostatectomy
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