Sural Nerve Grafting During Radical Prostatectomy
- 136 Downloads
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.
KeywordsRadical Prostatectomy Erectile Function Sural Nerve Radical Retropubic Prostatectomy Nerve Graft
Unable to display preview. Download preview PDF.
- 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.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
- 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
- 29.Kim ED. Improving radical prostatectomy-induced erectile function: new concepts pts. Contemp Urol November: 12-23, 20002.Google Scholar
- 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.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.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.Eastham J, Scardino P. Update on nerve grafting during radical prostatectomy. AUA News. 2003;January/February:40-41.Google Scholar
- 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.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
- 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