The nerve-sparing technique is a modified form of radical retropubic prostatectomy. The bundles of nerves on either side of the prostate gland are responsible for erections. If they appear to be cancer-free, they are not removed with the entire prostate gland. If the nerves are not damaged during surgery, men have a better chance of having erections again between two and 18 months after the operation.
Men can still have erections if only one nerve bundle is removed and can still have normal sex drive, sensation and orgasm if both bundles are removed.
Potency rates following nerve-sparing radical prostatectomy vary widely among surgeons and academic centers. In the hands of a highly skilled surgeon performing the technique in a center with extensive experience in the procedure, potency rates are much higher than the rates seen in community practice.
A study
of a medical center performing a high volume of this technique
for the treatment of localized prostate cancer reports an
86 percent potency rate 18 months after surgery1,
2. Studies from other health
centers report potency rates ranging from over 70 percent
to under 10 percent. Continence rates from these studies are
consistently high, ranging between 85 percent and 100 percent3.
1
Walsh PC. Radical prostatectomy for localized prostate cancer
provides durable cancer control with excellent quality of
life: a structured debate. J Urol 2000; 163(6):1802-7.
2
Walsh PC, Marschke P, Ricker D, Burnett AL. Patient-reported
urinary continence and sexual function after anatomic radical
prostatectomy. Urology 2000;55(1):58-61.
3
Sokoloff NH, Brendler CB. Radical retropubic prostatectomy.
Principles and Practice of Oncology Updates, Vol. 14,
No. 9. New York: Lippincott Williams & Wilkins Healthcare;
2000.
The Prostate Cancer pages of this Web site are part of the Comprehensive Prostate Cancer Awareness Program (CPCAP), a major regional effort to reduce the rates of death and illness caused by prostate cancer in southwestern Pennsylvania. Funding for CPCAP is provided by a grant from the Commonwealth of Pennsylvania.
