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Vol. 74, No. 4, 2005
Issue release date: May 2005
Section title: Original Paper
Urol Int 2005;74:308–314
(DOI:10.1159/000084428)

Efficacy of Unilateral Nerve Sparing in Radical Perineal Prostatectomy

Brehmer B. · Kirschner-Hermanns R. · Donner A. · Reineke T. · Knüchel-Clarke R. · Jakse G.
aUrological Clinic and bDepartment of Pathology, University Clinic, Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 11/25/2004
Accepted: 12/23/2004
Published online: 5/18/2005

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 5

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: http://www.karger.com/UIN

Abstract

Aim: We determine the efficacy of unilateral nerve-sparing radical perineal prostatectomy in preserving the sexual function. Patients and Methods: Ninety-two patients with histologically confirmed unilateral prostate cancer were scheduled for contralateral nerve preservation. The perioperative morbidity was assessed using the patients’ chart reviews. Postoperative health-related quality of life, urinary continence, and potency were evaluated prospectively with questionnaires provided before surgery and then after 6, 12, and 24 months. Results: Unilateral nerve preservation was performed in 88 of the 92 patients. Due to extensive scarring or prostatic size, the procedure was terminated as regular radical prostatectomy in 4 other patients. The perioperative complication rate was low and of minor significance, except in 1 patient who experienced a significant myoglobulinuria due to a prolonged procedure. Blood transfusions were necessary in 5 (5.4%) patients. Ureteral reimplantation was performed in 1 patient because of ureteral stricture. Positive surgical margins were present in 12 (18%) of 67 pT2 patients and in 8 (35%) of 23 pT3 patients. A proportion of 48% (15/31) of the patients followed for more than 24 months and who had a good erectile function prior to surgery reported unassisted sexual intercourse. However, only 4 of these patients were completely satisfied with all aspects of sexual performance, as asked in a short version of the International Index of Erectile Function questionnaire. Conclusions: Unilateral nerve-sparing radical perineal prostatectomy is technically feasible and yields excellent results in terms of potency preservation for prostates <60 ml. However, the quality of erections is decreased, even in patients with erections sufficient for intercourse. Hence, appropriate sexual counseling in conjunction with medical therapy should be offered to all patients.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 11/25/2004
Accepted: 12/23/2004
Published online: 5/18/2005

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 5

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: http://www.karger.com/UIN


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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    External Resources

  22. Rabbani F, Patel MI, Scardino PT: Time course of recovery of potency after bilateral nerve sparing radical prostatectomy (abstract 1178). J Urol 2004;171(suppl):310.
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  24. Catalona WJ, Carvalhal GF, Mager DE, Smith DS: Potency, continence and complication rates in 1,870 consecutive radical retropubic prostatectomies. J Urol 1999;162:433–438.
  25. Quinlan DM, Epstein JI, Carter BS, Walsh PC: Sexual function following radical prostatectomy: Influence of preservation of neurovascular bundles. J Urol 1991;145:998–1002.
  26. Rabbani F, Stapleton AM, Kattan MW, Wheeler TM, Scardino PT: Factors predicting recovery of erections after radical prostatectomy. J Urol 2000;164:1929–1934.
  27. Katz R, Salomon L, Hoznek A, de la Taille A, Vordos D, Cicco A, Chopin D, Abbou CC: Patient reported sexual function following laparoscopic radical prostatectomy. J Urol 2002;168:2078–2082.