Indication, Technique and Outcome of Retropubic Nerve-Sparing Radical Prostatectomy

Abstract

Retropubic radical prostatectomy is the most commonly used therapeutic option for the treatment of clinically localized prostate cancer. An ongoing stage migration towards organ-confined cancers allows to perform a nerve-sparing procedure in a growing number of patients. Key elements for achieving convincing functional results are a sphincter preserving ligation of the distal part of Santorini's plexus and the subtle preparation of the neurovascular bundle. This article gives a detailed description of our operative technique. Furthermore, a strategy for patient selection and tumor selection for the indication of nerve-sparing radical prostatectomy (NSRP) is suggested. In addition, functional results addressing postoperative urinary continence and potency are reported.