Variability of results of cavernous nerve stimulation during radical prostatectomy

被引:53
作者
Holzbeierlein, J [1 ]
Peterson, M [1 ]
Smith, JA [1 ]
机构
[1] Vanderbilt Univ, Med Ctr, Dept Urol Surg, Nashville, TN 38232 USA
关键词
prostatectomy; prostatic neoplasms; equipment and supplies; penile erection;
D O I
10.1097/00005392-200101000-00027
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: We assess the reliability of intraoperative cavernous nerve stimulation for producing an erectile response during radical prostatectomy. Materials and Methods: In 61 patients cavernous nerve function was assessed during radical retropubic prostatectomy using a CaverMap(double dagger) nerve stimulator. Control stimulation was also performed before and after prostatic dissection by placing the nerve stimulator tip on the anterior bladder wall. An increase in penile circumference measured by the device was considered a tumescence response while any measurable detumescence was also categorized. Results: Patient age ranged 43 to 72 years (mean 59.8). Before apical dissection 41% and 46% had tumescence, 31% and 21% had detumescence, and 28% and 33% had no response with stimulation of the neurovascular bundle and anterior bladder wall, respectively. After dissection 42% and 25% had tumescence, 16% and 18% had detumescence, and 42% and 57% had no response with stimulation of the neurovascular bundle and anterior bladder wall, respectively. Conclusions: A response to neurovascular bundle stimulation using this device does not necessarily correlate with the precise anatomical location of the cavernous nerves. There is considerable background variability related to anesthesia, surgical manipulation and other undefined factors that may cause minor but measurable changes in penile circumference.
引用
收藏
页码:108 / 110
页数:3
相关论文
共 6 条
[1]  
Klotz L, 1998, UROLOGY, V52, P537, DOI 10.1016/S0090-4295(98)00319-7
[2]   INTRAOPERATIVE ELECTROSTIMULATION OF THE CAVERNOUS NERVE - TECHNIQUE, RESULTS AND LIMITATIONS [J].
LUE, TF ;
GLEASON, CA ;
BROCK, GB ;
CARROLL, PR ;
TANAGHO, EA .
JOURNAL OF UROLOGY, 1995, 154 (04) :1426-1428
[3]   Is intraoperative electrostimulation of erectile nerves possible? [J].
Michl, U ;
Dietz, R ;
Huland, H .
JOURNAL OF UROLOGY, 1999, 162 (05) :1610-1613
[4]  
MYERS RP, 1994, AUA UPDATE SERIES, V13, P26
[5]   RADICAL PROSTATECTOMY WITH PRESERVATION OF SEXUAL FUNCTION - ANATOMICAL AND PATHOLOGICAL CONSIDERATIONS [J].
WALSH, PC ;
LEPOR, H ;
EGGLESTON, JC .
PROSTATE, 1983, 4 (05) :473-485
[6]   IMPOTENCE FOLLOWING RADICAL PROSTATECTOMY - INSIGHT INTO ETIOLOGY AND PREVENTION [J].
WALSH, PC ;
DONKER, PJ .
JOURNAL OF UROLOGY, 1982, 128 (03) :492-497