Nerve-sparing surgery and post-surgical sexual function: news from Kyoto

According to a report from Prof. Thomas Aherling on the UroToday web site, there were three interesting presentations related to nerve-sparing surgery at the recent World Conference of Endourology and SWL, in Kyoto Japan.

In the first of these presentations, Schatloff et al. presented data suggested that surgeons highly experienced in the conduct of robot-assisted radical prostatectomy are capable of a degree of surgical precision that can allow partial — as opposed to complete — resection of the neurovascular bundle, and that the surgeon’s personal assessment of the degree of precision could be correlated to postoperative pathologic findings. The implication is that nerve sparing may therefore be a “gradable” rather than an “all or nothing” experience, which has potrential implications for post-surgical sexual function. .

In a second presentation, Yates et al. offered data in support of earlier reserach suggesting that the size and/or the weight of a man’s prostate could significantly affect clinical outcomes over time. Specifically, this stdy showed than men with prostates weighing 68 grams or more tenmd to have less aggressive cancers and take longer to recover sexual function post-surgery.

In the third presentation, Smith et al. showed that by injecting water into and around the neurovascular bundles (NVBs) under ultrasound guidance prior to a radical prostatectomy one can potentially reduce risk for surgical traction injuries to the NVBs. Apparently, the injection of the water makes it easier to dissect the NVBs away from the prostate prior to surgical removal of the prostate.

The results of all three studies will still need to be confirmed by clinical researchers at other centers, but these studies do suggest the potential to continuously improve quality of outcomes in men undergoing radical surgery as a treatment for localized prostate cancer.

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