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Genitofemoral nerve grafting after radical prostatectomy and erectile function
Nerve grafting is used after radical prostatectomy to facilitate recovery of erectile function when the neurovascular bundle is widely resected because of high grade or extensive tumor. We used the genitofemoral nerve for either unilateral or bilateral grafting and assesed morbidity and functional results by questionairre. A 4cm segment of nerve was harvested and anastamosed to the cut ends of the neurovascular bundle using 5-0 prolene. Fewer than 10% of the patients reported any noticeable sensory loss in the ipsilateral thigh and, as the genitofemoral nerve has no motor innervation, none reported muscle weakness. Almost two thirds of the patients in the unilateral grafting group reported satisfactory erectile function 12 months after surgery. Whether this is a consequence of the nerve graft or an effective unilateral nerve sparing dissection on the contralateral side is uncertain.
Bibliographical reference:
Joseph Smith Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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