The nerve sparing radical prostatectomy: A step to better quality of life: Surgical aspects

Abstract

Radical surgical procedure (Radical Retropubic Prostatectomy) is treatment of choice for patients with localized (T1, T2) prostatic cancer. By radiologists, radical radiotherapy (brachi and external beam or only brachi therapy) could, also, be rational radical option for T1, T2. But, long-term survival is better after surgical procedure which is confirmed by many authors. Nerve sparing radical prostatectomy should be considered as a step to better life in all cases where it could be done. With this presentation we would like to point out the critical moments (the places of our-surgical mistakes), where Neurovascular Bundle (NVB) could be injured during the procedure (RRP). If those injures could be avoided urologist would be able to enhance the quality of life of these patients. The possible injures of NVB may happen during: 1. Dissection of the posterior wall of urethra. 2. Separation-dissection of external urethral sphincter. 3. Putting of sutures on urethra. 4. Preparation of the posterior side of prostate. 5. Dissection of the seminal vesicles. Careful surgical work of experienced urologist concerning all surgical tips mentioned above will result in an excellent continence (100%),preserved potency (more than 70%), and better quality of life for patients with localized prostate cancer.