[Nerve-sparing radical prostatectomy--effect and risks]

The purpose of nerve-sparing technique performing radical prostatectomy (NSRP) is to attempt to preserve the neurovascular bundle which is located posterolaterally on both sides of the prostate. The nerve-sparing technique presupposes the pre- and per operative tumour stage as well as preoperative erectile function--so as not to unnecessarily risk compromising the radicalism of the surgery.

In the period 2003-2006 242 patients were radical prostatectomized (RP) at the Dept. of Urology, Aarhus University Hospital, Skejby. A total of 84 of these were offered NSRP. Data concerning erectile function preoperatively and 12 months postoperatively were compared. Likewise the postoperative tumour control following NSRP was investigated.

There was a statistically significant association between NSRP and preserved potency 12 months postoperatively compared to the non-NSRP patient group. Moreover, no association between risks of positive surgical margins in patients treated with or without NSRP technique was observed. During follow up (median 39 months) the rate of biochemical recurrence was 40. Among these 8, 13 and 20% of the patients were respectively treated with bilateral-, unilateral- and non-NSRP.

NSRP seems to be both a safe and effective procedure in carefully selected patients. Furthermore, the results suggest that if preoperatively potent, low- to middle-risk group patients (cT1-2a/b, Gleason score < 7 and PSA < 10 ng/mL) are potential candidates for at least unilateral NSRP.