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Nerve Grafts Following Radical Prostatectomies

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Surgeons at the University of Melbourne have developed a new technique to repair nerve damage due to radical prostatectomies1.

Prostate cancer is the most frequently diagnosed cancer in men in the developed world, with 1.3 million new diagnoses each year. Treatment frequently involves the complete removal of the prostate and the adjacent seminal glands (a radical prostatectomy). Among men who undergo a radical prostatectomy (RP), 70-85% experience erectile dysfunction due to damage to nerves.

The new procedure involves removing a nerve from the leg, and grafting it to it to the side of the larger femoral nerve in the thigh. New nerve fibres then grew along the nerve graft into the corpora cavernosa of the penis.

In a clinical trial involving 17 patients with severe or moderate post-prostatectomy erectile dysfunction, erectile function was restore to 12 men (71%) within 12 months of the procedure. Of the 12, seven no longer required oral medications to achieve and maintain an erection.

The procedure is considered minimally invasive. Of the 21 subjects, there were two cases of minor postoperative infections.

In a previous trial involving 10 men, doctors in Brazil were able to restore erectile function to 6 (60%)2.


References

  1. Reece, Jeanette C; Dangerfield, David C; Coombs, Christopher J. “End-to-side Somatic-to-autonomic Nerve Grafting to Restore Erectile Function and Improve Quality of Life After Radical Prostatectomy.” European Urology. August 2019, Volume 76, Issue 2, Pages 189–196.
    <https://doi.org/10.1016/j.eururo.2019.03.036>
  2. Viterbo, Fausto; Trindade, José Carlos Souza; Trindade, André Petean; Fávaro, Wagner José; José Trindade-Filho, Carlos Souza. “Abstract: New Treatment of Erectile Dysfunction Post-Radical Prostatectomy Using Nerve Grafts and End-to-Side Neurorraphies.” Plastic and Reconstructive Surgery – Global Open. Sep 2017; 5(9 Suppl): 131-132.
    <https://dx.doi.org/10.1097%2F01.GOX.0000526353.22825.f1>

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