Nerve Stimulation Monitoring Devices in Radical Prostatectomy: A Narrative Review

Preservation of neurovascular bundles during radical prostatectomy is crucial for postoperative erectile function and urinary continence. Intraoperative nerve stimulation and neurophysiological monitoring devices have been developed to assist surgeons in identifying and preserving cavernous nerves, aiming to improve functional outcomes. A comprehensive review of the literature was conducted using the PubMed database, focusing on studies published within the last 10-15 years addressing intraoperative nerve stimulation and monitoring during radical prostatectomy. Multiple monitoring techniques have been described, including intracorporeal pressure measurement, penile tumescence monitoring, laser Doppler flowmetry, urethral pressure profilometry, and electromyography. While these methods are technically feasible and provide real-time functional feedback, evidence demonstrating a consistent and statistically significant improvement in postoperative erectile function or urinary continence remains limited. Current data do not support the routine use of intraoperative nerve stimulation monitoring devices during radical prostatectomy. Surgical experience, meticulous anatomical dissection, and minimal tissue manipulation remain the most important determinants of functional outcomes. Further large-scale, standardized prospective studies are required.