ABSTRACT
Several multivariate statistical models have been proposed to estimate pathological stage at RP with the intent of facilitating intraoperative decision making. Of these methods, the Partin tables represent the most widely used example, in which clinical stage, pretreatment prostatespecifi c antigen (PSA), and Gleason grade on prostate biopsy are used to predict pathological stage at RP.11 We have developed criteria by which patients unsuitable for nerve-sparing prostatectomy may be identifi ed based on an
increased potential for having ECE and PSMs. There are relatively few absolute contraindications to NVB preservation, but, rather, each individual case should be evaluated based on these clinical prognostic factors before a decision can be made to proceed with nerve preservation. Nomograms currently exist to assist in determining the risk and side of ECE in highrisk patients.12,13 Our indications for wide excision of the NVBs are as follows:
• Locally advanced disease (T3)
• Palpable disease at the apex
• Gleason grade 5 disease
• Serum PSA ≥20 ng/ml
• Preoperative impotence.
