Neurostimulationcaver Map

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During radical prostatectomy it is possible to evaluate the functional capacity of the neurovascular bundles with the CaverMap Surgical Aid. This device stimulates the cavernous nerves, which will produce a 1% or greater change in the circumference of the penile shaft if the bundles are intact.23 Several studies have attempted to correlate a positive Caver-Map response with recovery of potency postoperatively.23,24 Klotz and Herschorn found 94% of patients who had a positive CaverMap response intraoperatively had the ability to have erections after surgery.24 However, only 31% reported recovery with the ability to achieve erections consistently sufficient for penetration.24 This pilot study was also limited by small sample size.

Kim et al. reported that a positive CaverMap response poorly predicted recovery of potency after radical prostatec-tomy.23 A positive CaverMap response was noted in 77% of men but only 18% reported regaining sufficient potency for sexual intercourse.23 None of the patients who had both neurovascular bundles excised could achieve erections post-operatively. This group of patients also had a negative Caver-Map response, which validates the neurogenic component to erectile dysfunction. Because the high CaverMap response rate did not correlate with the low potency rate postopera-tively, it is hypothesized that erectile function is most likely a multifactorial process.

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