PC 03. Nerve - sparing laparoscopic radical prostatectomy: Report of 56 cases

Objective: To evaluate the impact of reservation of nervesparing laparoscopic radical prostatectomy (NSLRP) on the postoperative quality of life.

Methods: Laparoscopic radical prostatectomy was applied in 245 patients with localized prostate cancer (Pca) between February 2001 and July 2007. Of them, 56 patients with preoperative erectile function (IIEF5 scores ranged from 16 to 24) and indications (PSA <10 ng/mL; Gleason scores <7; Age <70 years old) underwent NSLRP. Among them, 39 cases had bilateral NSLRP, and 17 cases received unilateral NSLRP. After surgery, continually low-dose PDE5 inhibitor therapy, intracavernous injection, or vacuum constriction devices were performed for 3 months to restore the function of penis at the early stage. The patients' erectile function and urinary control were evaluated one year after the surgery.

Results: About 69% patients who had undergone NSLRP P preserved sexual function one year after the surgery, among which 28 patients (50%) regained the intercourse ability with the assist of PDE5 inhibitor. The IIEF5 scores ranged 0-7 in 11 cases (20%), 8-11 in 18 cases (32%), 13-21 in 23 cases (41%), and 22-25 in 4 cases (7%). Urinary control rate at 6 and 12 months after the surgery were 92% and 99.5%, respectively.

Conclusions: The NSLRP can effectively preserve most of the patients' sexual function and enhance the early recovery of erectile function and urinary continence. Low-dose PDE5 inhibitor after NSLRP can benefit the early recovery of erectile function.