Erectile dysfunction is a common problem after radical prostatectomy. In particular, spontaneous erections are absent in patients whose extent of prostate cancer requires bilateral resection of the neurovascular bundles as part of the radical prostatectomy procedure. A variety of noninvasive treatments are available, including vacuum constriction devices and intracavernosal injection therapy. However, spontaneous erectile activity is clearly preferred by patients.
Recently, there has been interest in sural nerve grafting to replace cavernous nerves resected at the time of prostatectomy. The sural nerve is considered expendable and has been used extensively in other nerve grafting procedures, such as brachial plexus and peripheral nerve injuries. As applied to prostatectomy, a portion of the sural nerve is harvested from one leg and then anastomosed to the divided ends of the cavernous nerve.
Sural nerve graft is considered experimental/investigational due to the lack of long-term studies when performed in association with resection of one or more neurovascular bundles as part of a radical prostatectomy.
Determined by the Urology Liaison committee at the 08-27-03 meeting and approved by the Medical Advisory Committee in November 2003.
(Web updated 2/2005)
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