Sunday, March 4, 2007

Nerve Grafts May Restore Erectile Function After Prostatectomy

Nerve Grafts May Restore Erectile Function After Prostatectomy: "'Although the sural nerve is considered the gold standard for grafting, genitofemoral nerves were also used in our study, based not only on the initial successful work by Quinn et al, but also on the ease of harvest and avoidance of potential complications related to sural nerve harvesting,' the clinicians note.
They found there was no 'statistically significant difference in erectile function recovery or the achievement of clinically meaningful erections using sural nerve grafts compared to genitofemoral nerves, even in the 28 patients with complete neurovascular bundle resection and no salvage radical prostatectomy after radiotherapy.'
Based on their experience, Dr. Secin and colleagues think bilateral cavernous nerve grafts might be beneficial in select patients, although a definitive answer awaits a multicenter, randomized, controlled trial."

I have never used nerve grafts as I was skeptical of them working. It doesn't make sense to me that nerve bundles, which are not discrete nerves, can coalesce and find a grafted nerve.

At least the morbidity of taking genito-femoral nerves is less than that of the sural nerve.


SeaSpray said...

Hi Dr. Savatta - I hope you don't mind that I am blogrolling you along with some other urology links I have on my site.

Thanks to my 1st kidney stone (6mm) ever,in time I ended up with a totally constricted ureter due to scarring and also a chronic hydronephrosis of the R kidney and a ureter that just wants to close.

I have been fortunate to have had an excellent urologist and group oversee my case this past year, who is now working along with someone else and so now I have the best in both areas. :)

I am hoping this last stent will have worked - but if not - I will be having a psoas hitch surgery in the spring. During the next 5 weeks before the renal scan, I am visualising a healed and open ureter, drinking aloe juice and just doing everything I can think of to facilitate the healing process. I didn't do this before and should have.

I am believing for a good outcome no matter which way it goes. I look forward to the day when I don't ever think about anything urological. (nothing personal)
A girl can dream! :)

Welcome to the blogging world. I accidentally discovered it when looking up urology info back in October and I discovered Urostream (She's great), got totally hooked and the rest is history.

Check out The Independent Urologist if you haven't already seen his blog.

Domenico Savatta, M.D. said...

Welcome to my blog.

Good luck with your problem. Hopefully things will heal fine for you. If it comes to surgery, you may want to consider robotics.

Ive done a fair amount of robotics for the ureter and bladder, including ureteral reimplants. Hopefully it will not to come to that at all though.

SeaSpray said...

Hi -What would be the criteria for ruling out the feasibility of performing robotics on a patient?

Is robotic surgery less invasive?

Thank you for the well wishes? :)