Nerve sparing versus nonnerve sparing

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Most men presenting with prostate cancer will have localized disease and, therefore, a long disease-free survival after treatment for their cancer.19 Successful treatment of prostate cancer not only depends on the length of time patients are cancer free, but also a patient's sexual function, which comprises a major component of their quality of life.19 It is recognized that nerve-sparing procedures provide the patient with a better quality of life and quicker return of erections.2,16 Quinlan etal. reported that there was a twofold increase in the risk of impotence when one neurovascular bundle was widely excised.2 This implies a neurogenic component to the physiologic mechanism of erection. Similarly, Geary etal. found that the potency rates increased with the number of neurovas-cular bundles spared.16 The number of intact neurovascular bundles was the most significant factor affecting postoperative potency.

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