[Oncologic risk of nerve sparing prostatectomy in patients with prostate cancer]

At the early 80-ties Walsh introduced nerve-sparing radical prostatectomy (NSRP) which includes sparing of neurovascular bundle. This allows persistence of erection following the surgery. Benefits from this improved technique are evident, nevertheless there exist a real threat of recurrencies due to not radical removal of tumorous tissues. The aim of the present paper is to assess the oncologic risk of NSRP in own material. During 1992-1997 a total of 39 radical prostatectomies (RP) were performed, 10 of them were NSRP. RP was in each case made by retropublical approach, according to Welsh. Of the 39 patients undergoing RP a normal sexual activity before surgery was declared by 26 (66.6%). In 14 patients with preserved sexual potency the neoplastic changes were limited to single lobe. Among 10 patients treated with NSRP in 3 the changes were found in both lobes, while in one of them the infiltration tended to invade along the neurovascular bundle. In 5 patients treated with NSRP erections were preserved. On base of obtained results it is concluded that NSRP is indicated only in patients with tumors localized only in one lobe of the prostate and preferably, at the early stage of tumour development. NSRP should be performed only in those patients, who before surgery declared no troubles with erections. Oncologic risk is higher in group with NSRP.