Robotic prostatectomy in detail
Before discovering the signs of complications, discover the symptoms to watch out for in our guide : What are the symptoms of prostate cancer?
Robotic-assisted radical prostatectomy is a state-of-the-art surgical procedure to treat localized prostate cancer. A major concern for many men is the preservation of erectile function after this procedure. This article explores the conditions under which erectile nerve preservation is possible and the factors that influence this crucial decision.
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Understanding Robotic Prostatectomy and Erectile Nerves
Robotic prostatectomy involves removal of the prostate and, potentially, surrounding tissue. The nerves responsible for erection are located close to the prostate. Preservation of these nerves is a priority to maintain erectile function post-operatively.
Key Factors for Nerve Preservation
Cancer stage and location:
- If the cancer is localized and far from the nerves, preservation is more likely.
- Advanced cancer or cancer close to the nerves may require more extensive removal.
Patient age and health:
- Younger patients with good pre-operative erectile function have a better chance of recovery.
- Pre-existing medical conditions may influence recovery.
Surgeon’s experience:
- The precision of the robotic technique and the surgeon’s expertise are crucial to successful nerve preservation.
Preoperative magnetic resonance imaging (MRI):
- MRI helps to localize the tumor before surgery.
The Importance of Preoperative Assessment
A thorough evaluation is essential to determine the feasibility of nerve preservation. This includes:
- Complete physical examination.
- Erectile function tests.
- MRI of the prostate to assess the extent of the cancer.
- PSA assay
Nerve Preservation Techniques
Robotic prostatectomy offers enhanced precision, enabling meticulous nerve dissection. Techniques include:
- Interfascial dissection: preserves nerves located between the prostate fascia.
- Intrafascial dissection: preserves nerves located very close to the prostate.
Expectations and Post-Operative Recovery
It’s important to note that nerve preservation does not guarantee immediate recovery of erectile function. Recovery may take several months or even years. Factors influencing recovery include:
- Extent of nerve preservation.
- Patient’s age and health.
- Post-operative rehabilitation.
Treatment Options for Post-Operative Erectile Dysfunction
Several options are available to treat erectile dysfunction after prostatectomy:
- Oral medications (PDE5 inhibitors).
- Intracavernosal injections.
- Vacuum devices.
- Penile prostheses.
Conclusion
Preserving the erectile nerves during prostatectomy for cancer is an important goal for improving patients’ quality of life. Thorough preoperative evaluation and precise surgical technique are essential to maximize the chances of success.
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