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• W2007434511 abstract "You have accessJournal of UrologyProstate Cancer: Localized VIII1 Apr 20101867 HYDRODISSECTION OF THE NEUROVASCULAR BUNDLES DURING RADICAL RETROPUBIC PROSTATECTOMY (RRP) IMPROVES POST OPERATIVE ERECTILE FUNCTION Daniel Spernat, Manish Patel, and Ernesto Lopez-Corona Daniel SpernatDaniel Spernat Cremorne, Australia More articles by this author , Manish PatelManish Patel Sydney, Australia More articles by this author , and Ernesto Lopez-CoronaErnesto Lopez-Corona Dodge City, KS More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1807AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To compare routine dissection (RD) of the neurovascular bundle during RRP with hydrodissection (HD). Hydro dissection is a common technique in plastic surgery and ophthalmology. METHODS HD of the neurovascular bundle involves injecting 20mL 1% Xylocaine with adrenaline in the tissue plane around the prostate capsule. A prospective database was collected recording SHIM scores preoperatively, at 6 weeks and 6 months postoperatively. Complete nerve sparing (NS), partial NS or nerve sacrifice was documented. Patients were excluded from the study if they were not sexually active. Routine nerve dissection was conducted 1/1/2005 to 31/5/2007 in 80 sexually active patients and constitutes the control arm. From 4/6/2007 to 15/7/2009 101 sexually active patients underwent HD. Statistical analysis with T test and Fishers exact test were performed. RESULTS There was no difference in pre-operative SHIM scores (21.9 vs 22.0, p=0.483) and mean age (58.2 vs 59.3, p=0.193) between men undergoing bilateral NS by RD or HD respectively. Postoperatively erectile dysfunction (ED) was reduced in the HD group. At 6 weeks postoperatively the mean SHIM score for RD was 9.9 vs 12.9 for HD (p=0.025). At 6 months there was also a significant difference in the mean SHIM score between the RD (15.25) and HD (18.56) groups (p=0.011). There was no difference in pre-operative SHIM scores (21.6 vs 20.5, p=0.501) and mean age (59.6 vs 60.2, p=0.626) between men undergoing unilateral partial resection by RD or HD respectively. Postoperatively erectile dysfunction (ED) was reduced in the HD group. At 6 weeks postoperatively the mean SHIM score for RD was 7.3 vs 10.0 for HD (p=0.112) and at 6 months there was a significant increased mean SHIM score for HD (17.6) group vs RD (13.8) group (p=0.031). Similar results were observed for men who had the equivalent of one nerve completely resected. Blood loss was also significantly reduced by HD (484ml) vs RD (769ml) (p=0.013). HD did not result in any change in positive margin rates (7.3% for RD and 8.8% for HD p=0.448). CONCLUSIONS HD of the neurovascular bundle improves postoperative erectile function in patients undergoing bilateral NS or unilateral partial nerve resection procedures. It also decreases blood loss without compromising positive margin rates. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e725 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Spernat Cremorne, Australia More articles by this author Manish Patel Sydney, Australia More articles by this author Ernesto Lopez-Corona Dodge City, KS More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2007434511 title "1867 HYDRODISSECTION OF THE NEUROVASCULAR BUNDLES DURING RADICAL RETROPUBIC PROSTATECTOMY (RRP) IMPROVES POST OPERATIVE ERECTILE FUNCTION" @default.
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