Penile reinnervation as a new technique for treating erectile dysfunction in patients after radical prostatectomy

Abstract

Nowadays, radical prostatectomy (RPE) is the «gold standard» in the treatment of localized prostate cancer (PCa). However, this intervention is associated with a high risk of developing iatrogenic erectile dysfunction (ED), which significantly reduces the quality of life of a man. One of the surgical solutions to this complication is the installation of a penile prosthesis. Nevertheless, it must be borne in mind that this manipulation is associated with certain risks of intra-and postoperative complications. During the operation, there may be complications such as perforation (cavernous, septal, urethral), crossover (intersection of rods or cylinders), haemorrhage, difficulties in suturing the operating wound, damage to the components of the prosthesis. The most common problem is an infection in the postoperative period. It is also worth noting the high cost of implants and artificial erection, which is crucial for some young patients. Countries around the world are searching for new methods to restore physiological erectile function in patients after RPE. Recently, the attention of specialists has been drawn to the possibility of restoring the innervation of the penis by transplanting a nerve graft. The study aimed to provide a general idea of the ED treatment in patients after RPE by nerve graft transplantation with the development and realization of our own described at the end as a clinical case.

Keywords

• erectile dysfunction
• radical prostatectomy
• penile innervation
• physiological erectile function