Nerve sparing radical prostatectomy: effects of hemostatic energy sources on the recovery of cavernous nerve function in a canine model

The Journal of Urology
Albert M OngP C Walsh

Abstract

To preserve sexual function following radical prostatectomy, one must avoid injury to the neurovascular bundles (NVBs). In the conventional open surgical technique, the use of energy sources for hemostasis is avoided to prevent damage to the cavernous nerves. In contrast, during laparoscopic radical prostatectomy, electrosurgical and ultrasonic energy sources are frequently used for hemostasis during dissection of the prostate. In this study, we evaluated the acute and chronic physiological effects of various hemostatic energy sources on cavernous nerve function in the canine model. A total of 12 dogs were divided into 4 groups based on the type of energy source used for hemostasis during unilateral dissection of the NVB. The groups included conventional dissection with suture ligatures (group 1), monopolar (group 2) or bipolar (group 3) electrosurgery and ultrasonic shears (group 4). The contralateral NVB was left undissected as a control. Erectile function was assessed acutely and after 2 weeks of survival by measuring peak intracavernous pressures in response to cavernous nerve stimulation. Following conventional techniques of nerve sparing, the erectile response to nerve stimulation was unaffected. In contrast, the use of e...Continue Reading

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Citations

Jun 15, 2006·Current Urology Reports·Matthew T Gettman, Michael L Blute
Apr 2, 2009·Journal of Endourology·Mohammed F SultanChristopher G Eden
Apr 19, 2008·Journal of Endourology·Thomas E AhleringDouglas W Skarecky
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Jan 25, 2007·BJU International·Troy R J GianduzzoChristopher G Eden

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