Preliminary results of a monitoring system to confirm the preservation of cavernous nerves

Kohei Kurokawa, Takanori Suzuki, Kazuhiro Suzuki, Naoki Terada, Kazuto Ito, Daisuke Yoshikawa, Yoichi Arai, Hidetoshi Yamanaka

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

Abstract

Background: It is important to preserve the neurovascular bundle (NVB) during nerve-sparing surgery. This article presents the preliminary results of our monitoring system for the postoperative preservation of erectile function. Methods: In 15 patients undergoing radical prostatectomy and 20 patients undergoing radical cystoprostatectomy, intraoperative electrical stimulation along the NVB was performed to measure changes in intracavernous pressure before and after prostate removal. Seven of the radical prostatectomy patients and eight of the radical cystoprostatectomy patients underwent nerve-sparing surgery. Postoperative erectile function was evaluated in 25 patients not receiving adjuvant hormonal therapy. Results: The NVB was judged to be preserved at least on one side electrophysiologically in 14 of 15 patients. Pathologically, three patients had pT3 cancer. Postoperatively, sufficient erectile function was demonstrated using the International Index of Erectile Function 5 in three patients, nocturnal penile tumescence in three patients, and a questionnaire or an interview in three patients. The other patients were incompletely erectile. None of the 11 patients not receiving adjuvant hormonal therapy, in whom NVB was not preserved, were erectile. Conclusion: If the successful criterion of nerve-sparing surgery is defined as a change in intracavernous pressure of 4 cm H2O or more being observed at least unilaterally, and the successful criteria of erectile function preservation includes being sufficiently erectile as revealed by an interview, the sensitivity of our system was 69.2% (9/13) and the specificity was 100% (12/12). Neither adverse reactions to the measurement, nor inadequacy of cancer excision accompanying NVB sparing, were observed. These results suggest that our system can predict postoperative erectile function fairly accurately.

Original languageEnglish
Pages (from-to)136-140
Number of pages5
JournalInternational Journal of Urology
Volume10
Issue number3
DOIs
Publication statusPublished - 2003 Mar 1

Keywords

  • Cavernous nerve
  • Electrical stimulation
  • Interim result
  • Intracavernous pressure
  • Nerve-sparing surgery

ASJC Scopus subject areas

  • Urology

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