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Related Concept Videos

Disorders of the Male Reproductive System01:20

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Men's health issues are increasingly recognized as significant, with several conditions posing common threats. Among these, testicular cancer is especially prevalent in younger men, particularly those aged 20 to 35 years. The disease often manifests as a painless mass in the testicles, sometimes accompanied by a sensation of heaviness or a dull ache.
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Sexual stimulation can take various forms, such as physical touch and visual or auditory cues. When this happens, the parasympathetic reflex in the sacral portion of the spinal cord is activated. This reflex stimulates the release of nitric oxide (NO), which then dilates the arterioles in the penis, increasing blood flow to the erectile tissues - the corpora cavernosa and corpus spongiosum.
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Related Experiment Video

Updated: Mar 25, 2026

Isolation of Adipose Derived Regenerative Cells for the Treatment of Erectile Dysfunction Following Radical Prostatectomy
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Erectile Function Recovery after Radical Prostatectomy in Men with High Risk Features.

Pedro Recabal1, Melissa Assel2, John E Musser3

  • 1Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Urology Service, Fundacion Arturo Lopez Perez, Santiago, Chile.

The Journal of Urology
|February 25, 2016
PubMed
Summary

Radical prostatectomy can achieve tumor excision while preserving erectile function in high-risk patients. Neurovascular bundle preservation is feasible, with nearly half of eligible men recovering erectile function post-surgery.

Keywords:
erectile dysfunctionprostatectomyprostatic neoplasms

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Area of Science:

  • Urology
  • Oncology

Background:

  • Radical prostatectomy is a primary treatment for prostate cancer.
  • High-risk prostate cancer presents unique surgical challenges regarding tumor excision and functional preservation.

Purpose of the Study:

  • To evaluate the efficacy of radical prostatectomy in achieving complete tumor excision and preserving erectile function in high-risk prostate cancer patients.
  • To assess the feasibility and outcomes of tailored neurovascular bundle preservation during radical prostatectomy for high-risk cases.

Main Methods:

  • Retrospective review of 584 high-risk prostate cancer patients (PSA ≥ 20 ng/ml, clinical stage T3+, Gleason grade 8-10) undergoing radical prostatectomy (2006-2012).
  • Analysis of preoperative factors influencing neurovascular bundle preservation probability.
  • Assessment of positive surgical margin rates and erectile function recovery in patients with preserved neurovascular bundles.

Main Results:

  • Neurovascular bundles were preserved to some degree bilaterally in the majority of patients.
  • Lower probability of preservation was associated with Gleason grade 5 and clinical stage T3 disease.
  • Among those with preserved bundles, 24% had positive surgical margins, and 47% of men with preoperatively functional erections recovered function within 2 years.

Conclusions:

  • Complete bilateral neurovascular bundle resection is not always necessary for high-risk prostate cancer.
  • High-volume surgeons can safely perform partial neurovascular bundle preservation in most high-risk patients, maintaining acceptable oncological outcomes.
  • Radical prostatectomy offers a significant chance of erectile function recovery for high-risk patients with pre-existing erectile function.