ABSTRACT
Radical prostatectomy has been associated with a loss of sexual potency in the majority of cases, owing to injury to the autonomic cavernous nerves. Since introduction of the anatomical approach to the neurovascular bundles by Walsh and Donker1, nerve-sparing radical prostatectomy has become the operation of choice in potent and sexually active men with organ-confined prostate carcinoma. Numerous reports of recovery of sexual potency after a nerve-sparing radical prostatectomy have been published since, showing a high rate of potency after the operation in a selected group of patients2,3. Most of these studies, however, have involved sexually active young patients with early-stage cancer and low cancer volume. In contrast, studies from community practices have shown a much lower rate of potency after radical prostatectomy4,5, questioning the feasibility of the nerve-sparing procedure in general urological practice.
