Intra-operative cavernous nerve monitoring and mapping during radical prostatectomy: a case report of corpus cavernosum electromyography

Abstract

Radical prostatectomy has a high risk of not only neurogenic bladder, which is being monitored through pudendal sensory evoked potentials and bulbocavernous reflex, but also erectile dysfunction (ED) and impotence. Corpus cavernous electromyography (CC-EMG) is a potential method to monitor from cavernous nerves to corpus cavernosum correlated directly with erectile function. This case report describes how to capture this CC-EMG signals of a man undergoing robotic radical prostatectomy using robotic forceps as a stimulation probe. With a good response of CC-EMG maintained during operation, this case represents a good clinical outcome regarding post-operative erectile function as well. Intraoperative nerve monitoring and mapping should include CC-EMG monitoring techniques during any surgeries manipulating low sacral levels in pelvic area, and further refinement and validation of CC-EMG monitoring should continue to use it clinically meaningful.