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UCLA Urology

Robotic Prostatectomy

Robotic Prostatectomy

Robotic Prostatectomy

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  • Prostate Nerve-Sparing
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  • Same-day: Robotic-assisted Prostatectomy
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Prostate Nerve-Sparing

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UCLA Institute of Urologic Oncology

Prostate Nerve-Sparing

A nerve-sparing radical prostatectomy is ultimately designed to preserve a man's sexual function. The success rate in preserving sexual potency is dependent on a few factors - a man's age, the quality of his erection prior to the surgery, and the surgeon's skill and experience in protecting and preserving the nerves during the Prostate nerve-sparing operation.
Nerve Sparing Prostatectomy >

In fact, it has been show that prostate nerve-sparing surgery is performed with tremendous variation. A recent study from Memorial Sloan Kettering showed that among 11 surgeons performing radical prostatectomy, 12-month sexual potency ranged from 8% to 50%, indicating that there is significant variation in technique and outcomes. Extending these findings beyond high volume academic centers suggests that men may receive suboptimal care.

The figures below are taken from three step-by-step guides that UCLA Urology faculty published to help other surgeons improve technique and outcomes. The figures demonstrates the landmarks for attaining the correct nerve sparing surgical plane and the equally important technique for minimizing trauma to the neurovascular bundle by avoiding stretch injury.

Nerve-sparing Technique Gallery (step-by-step guide)

1. SV Dissection 

1. SV dissection

1. SV Dissection 

2. Cut peel arteries

1. SV Dissection 

3. SV dissected Out

Defining Anterior Contour 

4. Defining anterior contour

Creating the Window 

5. Creating the window

Intrafascial Nervesparing 

6. Intrafascial nervesparing

Interfascial nerve-sparing higher risk 

7. Interfascial nerve-sparing higher risk

Suction counter-traction 

8. Suction counter-traction

R intermittent blunt dissection 

9. R intermittent blunt dissection

10. L intermittent blunt dissection 

10. L intermittent blunt dissection

11. R sharp dissection 

11. R sharp dissection

12. L vertical spread 

12. L vertical spread

13. lateral pedicle ligation. 

13. lateral pedicle ligation

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