Cavernous nerve graft reconstruction using an autologous nerve guide to restore potency

Abstract

To present our experience of cavernous nerve graft reconstruction, using an autologous nerve vein-guide technique, to restore potency. Prostate cancers frequently require radical resection involving one or both cavernous nerves that usually results in erectile dysfunction; nerve grafting has been used to restore erectile function, but clinical results are unsatisfactory owing to inadequate surgical techniques. In all, eight patients with prostate cancer who required radical resection involving one cavernous nerve had sural nerve grafting, with two or three sutures using the autologous vein-guide technique, in our unit between 2004 and 2005. Because of the difficulty of performing microsurgical manoeuvres deep within the pelvic cavity, the nerve anastomosis might be unsatisfactory. Seven of the eight patients had spontaneous erectile activity after grafting and six of these patients were able to have intercourse. Sural nerve grafting using the autologous vein-guide technique is simple, has minimal morbidity, and yields good outcomes.