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Sural Nerve Grafting During Radical Prostatectomy

Techniques and Results
  • Edward D. Kim
Chapter
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Part of the Current Clinical Urology book series (CCU)

Abstract

Advances in radical retropubic prostatectomy (RRP) technique have enabled surgeons to perform this procedure with diminished risks of troublesome morbidity, yet erectile dysfunction remains a significant concern. When both neurovascular bundles (NVBs) are preserved during RRP, potency rates of up to 71%, but generally closer to 30–60%, are observed (1–4).When both NVBs are intentionally resected, return of function is the exception. Interposition sural nerve grafting (SNG) during RRP offers men the increased possibility of maintaining spontaneous erections, which is “quantitatively related to preservation of autonomic innervation” when the cavernous nerves are resected (4).This technique represents a potential advance for the preservation of potency in RRP patients.

Keywords

Radical Prostatectomy Erectile Function Sural Nerve Radical Retropubic Prostatectomy Nerve Graft 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Catalona WJ, Carvalhal GF, Mager DE, et al. Potency, continence and complication rates in 1,870 consecutive radical retropubic prostatectomies. J Urol 1999; 162: 433 - 438.PubMedCrossRefGoogle Scholar
  2. 2.
    Davidson PJ, van den Ouden D, Schroeder FH. Radical prostatectomy: prospective assessment of mortality and morbidity. Eur Urol 1996; 29: 168 - 173.PubMedGoogle Scholar
  3. 3.
    Geary ES, Dendinger TE, Freiha FS, et al. Nerve sparing radical prostatectomy: a different view. J Urol 1995; 154: 145 - 149.PubMedCrossRefGoogle Scholar
  4. 4.
    Quinlan DM, Epstein JI, Carter BS, et al. Sexual function following radical prostatectomy: Influence of preservation of neurovascular bundles. J Urol 1991; 145: 998 - 1002.PubMedGoogle Scholar
  5. 5.
    Sunderland S. Nerve grafting and related methods of nerve repair. In: Sunderland S, ed. Nerve Injuries and Their Repair: A Critical Appraisal. Churchill Livingstone, Edinburgh, 1991, pp. 467 - 497.Google Scholar
  6. 6.
    Mackinnon SE, Dellon AL. Nerve injury and regeneration. In: Mackinnon SE, Dellon AL, eds. Surgery of the Peripheral Nerve. Thieme Medical Publishers, New York, 1988, pp. 140 - 152.Google Scholar
  7. 7.
    Schroder JM. Recommendations for the examination of peripheral nerve biopsies. Virchows Arch 1998; 432: 199 - 205.PubMedCrossRefGoogle Scholar
  8. 8.
    DeMoura W, Gilbert A. Surgical anatomy of the sural nerve. J Reconstr Microsurg 1984; 1: 31 - 39.CrossRefGoogle Scholar
  9. 9.
    Coert JH, Dellon AL. Clinical implications of the surgical anatomy of the sural nerve. Plast Reconstruct Surg 1994; 94: 850 - 855.CrossRefGoogle Scholar
  10. 10.
    Quinlan DM, Nelson RJ, Walsh PC. Cavernous nerve grafts restore erectile function in denervated rats. J Urol 1991; 145: 380 - 383.PubMedGoogle Scholar
  11. 11.
    Burgers JK, Nelson RJ, Quinlan DM, et al. Nerve growth factor, nerve grafts and amniotic membrane grafts restore erectile function in rats. J Urol 1991; 146: 463 - 468.PubMedGoogle Scholar
  12. 12.
    Ball RA, Richie J, Vickers MA. Microsurgical nerve graft repair of the ablated cavernosal nerves in the rat. J Surg Res 1992; 53: 280 - 286.PubMedCrossRefGoogle Scholar
  13. 13.
    Ball RA, Lipton SA, Dreyer EB, et al. Entubulization repair of severed cavernous nerves in the rat resulting in return of erectile function. J Urol 1992; 148: 211 - 215.PubMedGoogle Scholar
  14. 14.
    van Lith-Bijl JT, Stolk RJ, Tonnaer JA, et al. Laryngeal abductor reinnervation with a phrenic nerve transfer after a 9-month delay. Arch Otolaryngol Head Neck Surg 1998; 124: 393 - 398.PubMedGoogle Scholar
  15. 15.
    van Lith-Bijl JT, Stolk RJ, Tonnaer JA, et al. Selective laryngeal reinnervation with separate phrenic and ansa cervicalis nerve transfers. Archiv Otolaryngol Head Neck Surg 1997; 123: 406 - 411.CrossRefGoogle Scholar
  16. 16.
    Crumley RL. Selective reinnervation of vocal cord adductors in unilateral vocal cord paralysis. Ann Otol Rhinol Laryngol 1984; 93: 351 - 356.PubMedGoogle Scholar
  17. 17.
    Crumley RL, Horn K, Clendenning D. Laryngeal reinnervation using the split-phrenic nerve-graft procedure. Otolaryngol Head Neck Surg 1980; 88: 159 - 164.PubMedGoogle Scholar
  18. 18.
    Sato F, Saito H. Functional reconstruction for unilateral recurrent laryngeal nerve paralysis caused by thyroid cancer. Auris Nasus Larynx 1985; 12 (suppl 2): S210–S216.PubMedGoogle Scholar
  19. 19.
    Bernardi L, Valenti C, Wdowczyck-Szulc J, et al. Influence of type of surgery on the occurrence of parasympathetic reinnervation after cardiac transplantation. Circulation 1998; 97: 1368 - 1374.PubMedCrossRefGoogle Scholar
  20. 20.
    Tio RA, Reyners AK, van Veldhuisen DJ, et al. Evidence for differential sympathetic and parasympathetic reinnervation after heart transplantation in humans. J Autonom Nerv Syst 1997; 67: 176 - 183.CrossRefGoogle Scholar
  21. 21.
    Wesche J, Orning O, Eriksen M, Walloe L. Electrophysiological evidence of reinnervation of the transplanted human heart. Cardiology 1998; 89: 73 - 75.PubMedCrossRefGoogle Scholar
  22. 22.
    Walsh PC. Nerve grafts are rarely necessary and are unlikely to improve sexual function in men undergoing anatomic radical prostatectomy. Urology 2001; 57: 1020 - 1024.PubMedCrossRefGoogle Scholar
  23. 23.
    Kim ED, Scardino PT, Hampel O, et al. Interposition of sural nerve restores function of cavernous nerves resected during radical prostatectomy. J Urol 1999; 161: 188 - 192.PubMedCrossRefGoogle Scholar
  24. 24.
    Goad JR, Scardino PT. Modifications in the technique of radical retropubic prostatectomy to minimize blood loss. Atlas Urol Clin North Am 1994; 2: 65 - 74.Google Scholar
  25. 25.
    Kim ED, Scardino PT, Kadmon D, Slawin KM, Nath R. Interposition sural nerve grafting during radical prostatectomy. Urology 2001; 57: 211 - 216.PubMedCrossRefGoogle Scholar
  26. 26.
    Kim ED, Seo JT. A minimally invasive technique for sural nerve harvesting. Urology 2001; 57: 921 - 924.PubMedCrossRefGoogle Scholar
  27. 27.
    Millesi H. Healing of nerves. Clin Plast Surg 1977; 4: 459 - 473.PubMedGoogle Scholar
  28. 28.
    Sotereanos DG, Seaber AV, Urbaniak JR, et al. Reversing nerve-graft polarity in a rat model: the effect on function. J Reconstr Microsurg 1992; 8: 303 - 307.PubMedCrossRefGoogle Scholar
  29. 29.
    Kim ED. Improving radical prostatectomy-induced erectile function: new concepts pts. Contemp Urol November: 12-23, 20002.Google Scholar
  30. 30.
    Kim ED, Kadmon K, Slawin KM, Tang V, Nath R. Bilateral nerve grafts during radical retropubic prostatectomy: an extended follow-up. Urology 2001; 58: 983 - 987.PubMedCrossRefGoogle Scholar
  31. 31.
    Wood CG, Chang D, Kroll S, et al. Erectile function is preserved after non-nerve sparing radical prostatectomy through sural nerve interposition grafting. J Urol 2000;167:157, abstract 629.Google Scholar
  32. 32.
    Huang S, Swanson D, Pisters L, et al. Contralateral sural nerve grafting (SNG) after unilateral nerve sparing radical prostatectomy (RP) improves post-operative potency rates. J Urol 2002;167:344, abstract 1365.Google Scholar
  33. 33.
    Kadmon D, Nath R, Shariat S, et al. Unilateral interposition sural nerve grafting following ipsilateral neurovascular bundle resection at radical prostatectomy (RP) decreases the time to potency recovery. J Urol 2002; 167: 153.Google Scholar
  34. 34.
    Eastham J, Scardino P. Update on nerve grafting during radical prostatectomy. AUA News. 2003;January/February:40-41.Google Scholar
  35. 35.
    Singh H, Shariat S, Canto E, Kattan M, Karakiewicz P, Slawin K. Impact of interposition sural nerve graft on urinary control in patients undergoing radical prostatectomy. J Urol 2002;167:346, abstract 1374.Google Scholar
  36. 36.
    McKiernan J, Ohori M, Gerigk C, et al. Cavernous nerve graft reconstruction following radical prostatectomy in 77 patients: feasibility, safety and early results J Urol 2002;167:153, abstract 613.Google Scholar
  37. 37.
    Scardino PT, Kim ED. The rationale for nerve grafting during radical prostatectomy. Urology 2001; 57: 1016 - 1019.PubMedCrossRefGoogle Scholar
  38. 38.
    McKiernan JM, Ohori M, Gerigk C, et al. Cavernous graft reconstruction following radical prostatectomy in 77 patients: feasibility, safety and early results. J Urol Suppl 2001;165:149, abstract 613.Google Scholar
  39. 39.
    Slawin KM, Canto EI, Gore J, et al. Sural nerve interposition grafting during radical prostatectomy. Rev Urol 2002; 4: 17 - 23.PubMedGoogle Scholar
  40. 40.
    Canto EI, Nath RK, Slawin KM. Cavermap-assisted sural nerve interposition graft during radical prostatectomy. Urol Clin North Am 2001; 28: 839 - 848.PubMedCrossRefGoogle Scholar
  41. 41.
    Kaouk JH, Desai MM, Abreu SC, Papay F, Gill IS. Robotic-assisted laparoscopic sural nerve grafting during radical prostatectomy: initial experience. J Urol 2003; 3: 909 - 912.CrossRefGoogle Scholar
  42. 42.
    Srougi M, Pereira D, Dall‘Oglio M. Sexual rehabilitation after radical retropubic prostatectomy: new technique using ilio-inguinal nerve graft. ” Int Braz J Urol 2002; 28: 446 - 451.PubMedGoogle Scholar
  43. 43.
    Peunova N, Enikolopov G. Nitric oxide triggers a switch to growth arrest during differentiation of neuronal cells. Nature 1995; 375: 68 - 73.PubMedCrossRefGoogle Scholar
  44. 44.
    Sezen SF, Hoke A, Burnett AL, et al. Immunophilin ligand FK506 is neuroprotective for penile innervation. Nat Med 2001; 7: 1073 - 1074.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media New York 2004

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  • Edward D. Kim

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