Surgical technique of nerve sparing radical prostatectomy and periprostatic field anatomy

  • Ali Cansu Bozacı
  • Bülent Akdoğan
  • Haluk Özen

Bull Urooncol 2012;11(2):119-123

By the advances in diagnosis and treatment of prostate cancer in the last 3 decades, most of the prostate cancer patients are being diagnosed at an earlier stage. “Open Radical Prostatectomy” is one of the most preferred way to cure these group of patients. Although the main principle of this procedure is to achieve the best oncologic outcome, it is also important to recover erectile functions and urinary continence following surgery.

Surgeons must dominate the anatomic interactions of prostate such as; functional tissues like neuro-vascular bundle, urethral sphincter and facial layers covering it. Although there is no certain way, preoperative criteria can help surgeon to prefer the most suitable patient for nerve sparing. Outcomes of anatomic dissection studies, embryonic researches, and retrospective clinic studies can help urologist to understand prostatic anatomy better. Those studies had shown that new dissection planes could spare much more nerve fibers.

It is crucial that, the success of the procedure is best in survival and functional outcomes when performed by high volume surgeons at high volume centers.

Keywords: Prostate cancer, Surgical Anatomy, Nerve Sparing Radical Prostatectomy, Surgical Technique