Stepwise approach for nerve sparing without countertraction during robot-assisted radical prostatectomy: technique and outcomes

  • Kowalczyk K
  • Huang A
  • Hevelone N
 et al. 
  • 1


    Mendeley users who have this article in their library.
  • N/A


    Citations of this article.


BACKGROUND: Although subtle technical variation affects potency preservation during robot-assisted laparoscopic radical prostatectomy (RARP), most prostatectomy studies focus on achieving the optimal anatomic nerve-sparing dissection plane. However, the impact of active assistant/surgeon neurovascular bundle (NVB) countertraction on sexual function outcomes has not been studied or quantified. OBJECTIVE: To illustrate technique and compare sexual function outcomes for nerve sparing without (NS-0C) versus with (NS-C) assistant and/or surgeon NVB countertraction. DESIGN, SETTING, AND PARTICIPANTS: This is a retrospective study of 342 NS-0C versus 268 NS-C RARP procedures performed between August 2008 and February 2011. SURGICAL PROCEDURE: RARP. MEASUREMENTS: We used the Expanded Prostate Cancer Index Composite (EPIC) sexual function and potency scores, estimated blood loss (EBL), operative time, and positive surgical margin (PSM). RESULTS AND LIMITATIONS: In unadjusted analysis, men undergoing NS-0C versus NS-C were older, had worse baseline sexual function, higher biopsy and pathologic Gleason grade, and higher preoperative prostate-specific antigen (PSA) levels (all p

Author-supplied keywords

  • *Laparoscopy/adverse effects
  • *Robotics
  • *Surgery, Computer-Assisted/adverse effects
  • Aged
  • Boston
  • Chi-Square Distribution
  • Erectile Dysfunction/etiology/physiopathology/prev
  • Humans
  • Linear Models
  • Logistic Models
  • Male
  • Middle Aged
  • Penile Erection
  • Prostatectomy/adverse effects/*methods
  • Prostatic Neoplasms/*surgery
  • Recovery of Function
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Find this document


  • K J Kowalczyk

  • A C Huang

  • N D Hevelone

  • S R Lipsitz

  • H Y Yu

  • W D Ulmer

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free