| ORIGINAL ARTICLE |
|
| Year : 2014 | Volume
: 30
| Issue : 3 | Page : 268-272 |
|
|
Histological evaluation of nerve sparing technique in robotic assisted radical prostatectomy
Kazushi Tanaka, Katsumi Shigemura, Nobuyuki Hinata, Mototsugu Muramaki, Hideaki Miyake, Masato Fujisawa
Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan
Correspondence Address:
Katsumi Shigemura
Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017
Japan
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0970-1591.128500
|
|
|
Introduction: The objective of this study is to compare intrafascial nerve-sparing (NS), interfascial NS and non-NS prostatecomy specimens to assess the feasibility of NS technique in Robot-assisted radical prostatectomies (RARP).
Materials and Methods: The records of the first 43 consecutive patients (86 prostatic sides (lobe) who underwent NS RARP (6 intrafascial NS, 46 interfacial NS, 34 non-NS) were reviewed and histopathological examinations were performed. The presence and distribution of periprostatic neurovascular structures were histologically evaluated using mid-gland section of each prostate lobe in the prostatectomy specimen and it was immunostained with the S-100 antibody for quantitative analysis of nerves.
Results: The average number of nerve fibers per prostatic half was 37.2 ± 20.6. The number of resected peri-prostatic nerves counted was 13.7 ± 13.5, 30.5 ± 15.0 and 50.4 ± 20.4 in intrafascial NS, interfascial NS and non-NS specimens, respectively. The difference in the number of nerve bundle counts in the three groups was statistically significant (P < 0.05). Patients with urinary continence at 6 months after surgery had significantly less number of nerve fibers resected with the prostate than the incontinence group (P = 0.013) and the number of nerve fi bers resected in the potent group were lower than in the impotent group but did not reach statistical significance (P = 0.057).
Conclusions: Our study showed that NS RARP could be performed according to surgeons' intention (intrafascial, interfascial or non-NS) and urinary continence significantly correlated to the number of nerve fibers resected with the prostate. |
|
|
|
| [FULL TEXT] [PDF]* |
|
 |
|
