Pre-and postoperative evaluation of cavernous autonomic innervation after nerve sparing radical cystoprostatectomy and radical retropubic prostatectomy

ABSTRACT

To assess the cavernous autonomic innervation using Single Potential Analysis of Cavernous Electrical Activity following nerve sparing radical pros tatectomy and cystoprostatectomy. This study was conducted on 23 cancer patients, 20 with invasive bladder cancer and three patients with cancer prostate [mean age 58.4, range 40- 71] operated upon using nerve sparing technique. Postoperative assessment of integrity of the cavernous innervation was done using single potential analysis of cavernous electrical activity [SPACE device]. Subjective and objective assessment of the erectile function was done pre- and postoperatively. Erectile function was preserved in 74% of patients 12 months following surgery, despite the sign drop in the mean erectile function score. The mean time for return of erection was 4.6 +1.6 months. which showed statistically sign positive correlation with the age at operation [r = 0.749, p value 0.00004]. SPACE device is a useful diagnostic tool in detecting the integrity of the cavernous nerves following nerve-sparing technique. The age at operation, and meticulous dissection of the neurovascular bundles, were significant factors for the return of postoperative potency