In a nutshell
This article investigated the safety and efficacy of end-to-side nerve grafting surgery (NGS) in patients with erectile dysfunction (ED) after prostate surgery. The authors concluded that NGS was a safe and effective treatment option for these patients.
Some background
Radical prostatectomy (RP) is surgery to remove the prostate. It is the main treatment recommended for men with localized prostate cancer. However, RP is often associated with erectile dysfunction (ED). Men with ED have trouble having an erection firm enough to to have sexual intercourse. This leads to a poor quality of life.
Several treatment options are available for men with ED after RP. These include medications, injections into the penis or penis pumps. However, these do not work for all patients. An additional therapy is end-to-side nerve grafting surgery (NGS). This involves connecting a nerve graft to the side of the femoral nerve in the thigh. This leads to a part of the femoral nerve to branch off and grow into the penis where it can restore the nerve connections. This may restore sexual function. The safety and effectiveness of end-to-side NGS in men with ED after RP remain under investigation.
Methods & findings
The study involved 17 male patients. All men had ED after the RP. All patients underwent end-to-side NGS at an average of 2.2 – 2.4 years after the RP. Patients were followed up for an average of 18 months after the NGS.
1 year after NGS, 71% of the patients had erectile function recovery sufficient for satisfactory sexual intercourse. 94% had improvements in sexual function and 82% had reduced bother. 2 patients out of the 17 had minor wound infections.
The bottom line
The authors concluded that end-to-side NGS was a safe and effective treatment option for patients with ED after RP.
The fine print
This study included a very small number of patients. Larger studies are needed to confirm these results.
Published By :
European Urology
Date :
Apr 04, 2019
