Technical advances in nerve-sparing and continence preservation. Issue 2 (March 2022)

• Record Type: Journal Article
• Authors: Pedraza, Adriana M.; Wagaskar, Vinayak; Parekh, Sneha; Tewari, Ashutosh
• Is Part Of: Current opinion in urology. Volume 32:Issue 2(2022)
• Publication Date: 2022-03
• Subjects: nerve-sparing -- robotic-assisted radical prostatectomy -- urinary continence; Urology -- Periodicals; Review Literature -- Bibliography; Review Literature -- Periodicals; Male Urogenital Diseases -- Bibliography; Male Urogenital Diseases -- Periodicals; Female Urogenital Diseases -- Bibliography; Female Urogenital Diseases -- Periodicals; Urologic Diseases -- Bibliography; Urologic Diseases -- Periodicals; Periodicals; 616.6005
• DOI: 10.1097/MOU.0000000000000958
• Languages: English
• ISSNs: 1473-6586

Abstract

Abstract : Purpose of review: Urinary incontinence and erectile dysfunction are common after radical prostatectomy. These side effects greatly impact patients' quality of life. Therefore, surgical techniques and technology tools are constantly being developed to optimize trifecta outcomes. Here we focus on advances in nerve-sparing (NS) and continence preservation. Recent findings: New surgical techniques dedicated to preservation rather than reconstruction have been developed to improve urinary continence (UC) and NS. On the other hand, intraoperative assessment of prostatic and periprostatic structures has shown promising outcomes toward NS whereas avoiding omission of extracapsular extension (ECE). Likewise, neural regeneration strategies are under research to improve return of erectile function and UC. Summary: Superb outcomes after Robot-Assisted Radical Prostatectomy require a proper balance between NS and risk of ECE. Detailed anatomic knowledge together with an accurate surgical planning are cornerstone for tailoring the approach in each case.