Nerve sparing and continence preservation during radical prostatectomy

Prostate cancer is one of the most common malignancies occurring in men. During the last decade, several advances have been made in decreasing the morbidity of surgical therapy. Two major advances have included an improved understanding of the physiology of erection and anatomy of pelvic parasympathetic nerves mediating erectile function. Surgical techniques of 'nerve preservation' during surgery can preserve postoperative potency in 50-70% of patients with localized prostate cancer. In others the use of intracorporal vasoactive agents, vacuum suction devices and surgical techniques can additionally improve potency. Knowledge of the various mechanisms contributing to continence have additionally enabled modifications in surgical techniques to enhance continence rates postoperatively. Currently postoperative continence after radical prostatectomy occurs in over 95% of patients.