Neurostimulation during radical prostatectomy: improving nerve-sparing techniques

Considerable variation exists in the reported results of nerve-sparing prostatectomy with respect to potency preservation. This may reflect differences in surgical technique. The Cavermap is a device that uses intraoperative nerve stimulation with real time tumescence monitoring to permit identification of the course of the cavernous nerve fibers during radical prostatectomy. Results of a single center phase 2 and a blinded multicenter phase 3 study have demonstrated an improved outcome compared with conventional nerve sparing with respect to Rigiscan-measured nocturnal erection at 1 year after prostatectomy. The device permits evaluation of the success of nerve-sparing during surgery. Further studies of the effectiveness of the Cavermap device are warranted.