Impact of Unilateral Sural Nerve Graft on Recovery of Potency and Continence Following Radical Prostatectomy: 3-Year Longitudinal Study

Shunichi Namiki, Seiichi Saito, Haruo Nakagawa, Takehiko Sanada, Atsushi Yamada, Yoichi Arai

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Purpose: We conducted a 3-year longitudinal study assessing the impact of unilateral sural nerve graft on recovery of potency and continence following radical prostatectomy. Materials and Methods: A total of 113 patients undergoing radical retropubic prostatectomy were classified into 3 groups according to the degree of nerve sparing, that is unilateral nerve preservation with contralateral sural nerve graft interposition, bilateral nerve sparing and unilateral nerve sparing. Urinary continence and potency were estimated by the UCLA Prostate Cancer Index questionnaire. Results: Patients in the nerve sparing plus sural nerve graft group were younger than those in the bilateral nerve sparing or unilateral nerve sparing groups. At baseline the unilateral nerve sparing plus sural nerve graft group and the bilateral nerve sparing group reported better sexual function than the unilateral nerve sparing group (62.1 and 61.5 vs 49.9, p <0.05). The bilateral nerve sparing group showed more rapid recovery than the unilateral nerve sparing plus sural nerve graft group after radical retropubic prostatectomy (p <0.01). After 24 months there were no significant differences observed between the bilateral nerve sparing and the unilateral nerve sparing plus sural nerve graft group (28.7 vs 32.9). The bilateral nerve sparing group reported a better sexual function score than the unilateral nerve sparing group throughout the postoperative period (p <0.05). The bilateral nerve sparing group maintained significantly better urinary function at 1 month after radical retropubic prostatectomy than the unilateral nerve sparing plus sural nerve graft group (p <0.05). After 3 months these groups were almost continent. The unilateral nerve sparing group reported lower urinary function scores during the first year compared to the other groups. Conclusions: The nerve graft procedure may contribute to the recovery of urinary function as well as sexual function after radical retropubic prostatectomy. This finding needs to be validated in a randomized trial.

Original languageEnglish
Pages (from-to)212-216
Number of pages5
JournalJournal of Urology
Volume178
Issue number1
DOIs
Publication statusPublished - 2007 Jul

Keywords

  • impotence
  • prostatectomy
  • prostatic neoplasms
  • sural nerve
  • urinary incontinence

ASJC Scopus subject areas

  • Urology

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