Different Nerve-Sparing Techniques during Radical Prostatectomy and Their Impact on Functional Outcomes
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”, “prostatect...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/7/1601 |
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| author | Iason Kyriazis Theodoros Spinos Arman Tsaturyan Panagiotis Kallidonis Jens Uwe Stolzenburg Evangelos Liatsikos |
| author_facet | Iason Kyriazis Theodoros Spinos Arman Tsaturyan Panagiotis Kallidonis Jens Uwe Stolzenburg Evangelos Liatsikos |
| author_sort | Iason Kyriazis |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T12:04:28Z |
| format | Article |
| id | doaj.art-295ed52f8d32435e9073603b05eff1fe |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T12:04:28Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-295ed52f8d32435e9073603b05eff1fe2023-11-30T22:59:25ZengMDPI AGCancers2072-66942022-03-01147160110.3390/cancers14071601Different Nerve-Sparing Techniques during Radical Prostatectomy and Their Impact on Functional OutcomesIason Kyriazis0Theodoros Spinos1Arman Tsaturyan2Panagiotis Kallidonis3Jens Uwe Stolzenburg4Evangelos Liatsikos5Department of Urology, University of Patras, 26504 Patras, GreeceDepartment of Urology, University of Patras, 26504 Patras, GreeceDepartment of Urology, University of Patras, 26504 Patras, GreeceDepartment of Urology, University of Patras, 26504 Patras, GreeceDepartment of Urology, University Hospital of Leipzig, 04103 Leipzig, GermanyDepartment of Urology, University of Patras, 26504 Patras, GreeceThe 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.https://www.mdpi.com/2072-6694/14/7/1601prostate cancerradical prostatectomynerve-sparingtechniquesfunctionaloutcomes |
| spellingShingle | Iason Kyriazis Theodoros Spinos Arman Tsaturyan Panagiotis Kallidonis Jens Uwe Stolzenburg Evangelos Liatsikos Different Nerve-Sparing Techniques during Radical Prostatectomy and Their Impact on Functional Outcomes Cancers prostate cancer radical prostatectomy nerve-sparing techniques functional outcomes |
| title | Different Nerve-Sparing Techniques during Radical Prostatectomy and Their Impact on Functional Outcomes |
| title_full | Different Nerve-Sparing Techniques during Radical Prostatectomy and Their Impact on Functional Outcomes |
| title_fullStr | Different Nerve-Sparing Techniques during Radical Prostatectomy and Their Impact on Functional Outcomes |
| title_full_unstemmed | Different Nerve-Sparing Techniques during Radical Prostatectomy and Their Impact on Functional Outcomes |
| title_short | Different Nerve-Sparing Techniques during Radical Prostatectomy and Their Impact on Functional Outcomes |
| title_sort | different nerve sparing techniques during radical prostatectomy and their impact on functional outcomes |
| topic | prostate cancer radical prostatectomy nerve-sparing techniques functional outcomes |
| url | https://www.mdpi.com/2072-6694/14/7/1601 |
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