Journal
CURRENT OPINION IN UROLOGY
Volume 21, Issue 1, Pages 49-59Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOU.0b013e32834120e9
Keywords
athermal; hammock; nerve-sparing; neuroanatomy; potency; prostate cancer; prostatectomy; robotic; traction-free
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Funding
- Intuitive Surgical, Inc. (Sunnyvale, California, USA)
- Prostate Cancer Foundation
- National Institute of Bioimaging and Bioengineering [R01 EB009388-01]
- Prostate UK
- NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING [R01EB009388] Funding Source: NIH RePORTER
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Purpose of review Much of the progress achieved in the past two decades in improving potency outcomes after radical prostatectomy has resulted from an improved appreciation of the anatomic basis of the nerves responsible for erection. We review the current literature evaluating the neuroanatomy of prostate and operative strategies for better preservation of sexual function. Recent findings Recent studies suggest an alternative and more complex course of nerves than previously described. Periprostatic nerves can be divided into three broad surgically identifiable zones: the proximal neurovascular plate, the predominant neurovascular bundle, and the accessory neural pathways. Better appreciation of the variable and often invisible anatomical course of the cavernosal nerves continues to engender innovations in surgical technique to optimize their preservation. Summary Improved anatomic understanding has optimized surgical technique in order to improve potency outcomes following radical prostatectomy.
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