Anatomical aspects of the neurovascular bundle in prostate surgery

Prasanna Sooriakumaran, Gerald Y. Tan, Sonal Grover, Atsushi Takenaka, Ashutosh K. Tewari

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

2 Scopus citations


Over recent years, widespread prostate-specific antigen screening has resulted in a downwards stage migration of prostate cancer in developed nations, with most patients being diagnosed nowadays at a younger age with early organ-confined disease [1–3]. Radical prostatectomy has a proven survival benefit over conservative treatment [4, 5], and thus is the gold standard for the management of clinically localized prostate cancer. Hence, with more patients undergoing surgery, minimizing functional loss is of utmost importance. However, despite recent advances in surgical technique and technologies, return of erectile function sufficient for sexual intercourse at 1 year after surgery varies from 15 to 87 %, respectively, in contemporary series of radical prostatectomy [6–8]. For younger men, postprostatectomy erectile dysfunction (PPED) significantly affects their sense of masculinity and their daily interactions with women [9, 10]. Patient age, clinical and pathological stage of cancer, preoperative potency status, and aggressiveness of nerve-sparing are the most significant factors for recovery of potency after surgery [11–13]. Surgeon experience and surgical volume, penile ischemia and subsequent fibrosis, and veno-occlusive disease are also important for successful return of sexual function following surgery [14, 15].

Original languageEnglish
Title of host publicationRobotic Urology
Subtitle of host publicationSecond Edition
PublisherSpringer Berlin Heidelberg
Number of pages9
ISBN (Electronic)9783642332159
ISBN (Print)9783642332142
StatePublished - 1 Jan 2013
Externally publishedYes


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