Cavernous Nerve Reconstruction During Radical Prostatectomy by Sural Nerve Grafting: Surgical Technique in Nerve Harvesting and Grafting

Gan Muneuchi; Yoshihiro Kuwata; Shigeo Taketa; Masashi Inui; Fumio Tsukuda; Osamu Shimada; Hiroharu H. Igawa; Yoshiyuki Kakehi

doi:10.1055/s-2005-922430

Journal of Reconstructive Microsurgery, Table of Contents

J Reconstr Microsurg 2005; 21(8): 525-529
DOI: 10.1055/s-2005-922430

Cavernous Nerve Reconstruction During Radical Prostatectomy by Sural Nerve Grafting: Surgical Technique in Nerve Harvesting and Grafting

Gan Muneuchi¹ , Yoshihiro Kuwata² , Shigeo Taketa² , Masashi Inui² , Fumio Tsukuda² , Osamu Shimada² , Hiroharu H. Igawa¹ , Yoshiyuki Kakehi¹

¹Department of Plastic and Reconstructive Surgery, Kagawa University, Kagawa, Japan
²Department of Urology, Kagawa University, Kagawa, Japan

Abstract

ABSTRACT

The authors performed cavernous nerve reconstruction by nerve grafting in 22 patients (unilateral-16, bilateral-6) between August 2001 and June 2004. Harvesting of the sural nerve was unexpectedly more difficult than nerve grafting in the extremities or the head and neck, because a knee and lumbar bending position was impossible due to the pelvic surgical field. Suture of the grafted nerve on the distal side required great effort, because there was only sufficient space for one hand at the maximum in a deep region of the pelvic cavity, and the nerve ends easily become invisible by inflow of even a small amount of urine or blood. The mean time of the nerve harvesting and grafting was 1 hr 50 min for unilateral grafting and 2 hr 40 min for bilateral grafting. Recovery of erectile function was observed in about half the patients who had undergone surgery nearly 1 year before. Since harvesting of the sural nerve and nerve grafting were more difficult than expected, modification and improvement of many surgical elements, such as improvement of surgical devices and application of endoscopic techniques, are necessary.

KEYWORDS

Cavernous nerve of the penis - prostate cancer - erectile dysfuction - nerve graft - sural nerve

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References

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Gan MuneuchiM.D.

Department of Plastic and Reconstructive Surgery, Kagawa University

1750-1, Ikenobe, Miki, Kita, Kagawa 761-0793, Japan