The purpose of this narrative review is to describe the different nerve-sparing techniques applied during radical prostatectomy and document their functional impact on postoperative outcomes.
We performed a PubMed search of the literature using the keywords “nerve-sparing”, “techniques”,
“prostatectomy” and “outcomes”. Other potentially eligible studies were retrieved using the reference
list of the included studies. Nerve-sparing techniques can be distinguished based on the fascial
planes of dissection (intrafascial, interfascial or extrafascial), the direction of dissection (retrograde or
antegrade), the timing of the neurovascular bundle dissection off the prostate (early vs. late release),
the use of cautery, the application of traction and the number of the neurovascular bundles which are
preserved. Despite this rough categorisation, many techniques have been developed which cannot be
integrated in one of the categories described above. Moreover, emerging technologies have entered
the nerve-sparing field, making its future even more promising. Bilateral nerve-sparing of maximal
extent, athermal dissection of the neurovascular bundles with avoidance of traction and utilization of
the correct planes remain the basic principles for achieving optimum functional outcomes. Given that
potency and continence outcomes after radical prostatectomy are multifactorial endpoints in addition
to the difficulty in their postoperative assessment and the well-documented discrepancy existing
in their definition, safe conclusions about the superiority of one technique over the other cannot be
easily drawn. Further studies, comparing the different nerve-sparing techniques, are necessary.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:85989 |
| Date | 13 June 2023 |
| Creators | Kyriazis, Iason, Spinos, Theodoras, Tsaturyan, Arman, Kallidonis, Panagiotis, Stolzenburg, Jens Uwe, Liatsikos, Evangelos |
| Publisher | MDPI |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 1601 |
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