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Updated: Apr 5, 2026

Retzius-Sparing Robot-Assisted Radical Prostatectomy
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Novel methods for mapping the cavernous nerves during radical prostatectomy.

Nathaniel M Fried1, Arthur L Burnett2

  • 1Department of Physics and Optical Science, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA.

Nature Reviews. Urology
|August 11, 2015
PubMed
Summary

Preserving cavernous nerves during radical prostatectomy is crucial for erectile function. New technologies and combined approaches show promise for improving nerve preservation and patient quality of life after surgery.

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Area of Science:

  • Urology
  • Neuroscience
  • Medical Technology

Background:

  • The cavernous nerves are essential for erectile function and run along the prostate gland.
  • Radical prostatectomy poses challenges in preserving these microscopic nerves due to their variable location.
  • Postoperative sexual potency rates vary significantly after radical prostatectomy.

Purpose of the Study:

  • To review existing and emerging technologies for identifying and preserving cavernous nerves during radical prostatectomy.
  • To highlight the limitations of current technologies and the potential of novel approaches.
  • To discuss the impact of nerve preservation on postoperative sexual outcomes and patient quality of life.

Main Methods:

  • Review of existing literature on technologies for cavernous nerve study and intraoperative identification.

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  • Analysis of limitations associated with electrical and optical nerve stimulation, fluorescence, microscopy, spectroscopy, ultrasound, and MRI.
  • Exploration of potential benefits of new and emerging technologies and multimodal approaches.

    • Main Results:

    • Current technologies for cavernous nerve identification have limitations including poor resolution, slow acquisition, and safety concerns.
    • No single technology has proven consistently effective for intraoperative nerve preservation.
    • Emerging technologies and multimodal strategies offer potential for improved outcomes.

    Conclusions:

    • Improved methods for cavernous nerve identification and preservation are needed to enhance sexual function after radical prostatectomy.
    • Multimodal approaches combining existing and novel technologies may offer the most promising path forward.
    • Advancements in this area are critical for improving patient quality of life post-surgery.