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Urol Int. 2005;75(2):175-80.

Seminal monolateral nerve-sparing radical prostatectomy in selected patients.

Author information

1
Division of Urology, Ospedale Degli Infermi, Rivoli, Italy. mauromari@yahoo.com

Abstract

INTRODUCTION:

In recent years there has been a shift in prostate cancer stage with the majority of patients nowadays being operated with cT1c disease, prostate-specific antigen levels of <10 ng/ml, and a decreased rate of seminal vesicle invasion. Recent data suggest the role of preservation of the seminal vesicle in improving continence and/or potency. We describe our preliminary experience with seminal-sparing, unilateral nerve-sparing retropubic radical prostatectomy.

PATIENTS AND METHODS:

21 selected patients with clinically localized prostate cancer underwent seminal unilateral nerve-sparing retropubic radical prostatectomy (seminal-sparing group, SSG). We compared the postoperative continence, erectile function and quality of orgasm results to those obtained in a control group (CG) of 21 patients who underwent unilateral nerve-sparing radical prostatectomy. Sexual function was evaluated preoperatively and 9 months postoperatively with the 5-item International Index of Erectile Function (IIEF-5) questionnaire and with other self-administered questionnaires. The quality of orgasm was evaluated 9 months postoperatively.

RESULTS:

1 month postoperatively, 95 and 28% of the patients in the SSG and CG were continent (p<0.001). The median postoperative drop in IIEF-5 score was 5 points in SSG and 14.5 points in CG (p<0.0001). Nine months postoperatively, 90 and 62% of the patients in SSG and CG, respectively (p=0.05), maintained the ability to achieve orgasm.

CONCLUSIONS:

In our experience seminal-sparing radical prostatectomy showed good feasibility and improved early postoperative urinary continence, erectile function and quality of orgasm, without compromised cancer control.

PMID:
16123574
DOI:
10.1159/000087174
[Indexed for MEDLINE]
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