after Radical Prostatectomy
Volume 9, Winter 2013
Arthur Burnett, right, with Urology fellow
Robert Segal: Because the nerves lack
protective insulation, they are vulnerable
to injury during surgery..
As its name suggests, the nerve-sparing radical prostatectomy is designed to preserve, as much as possible, the bundles of nerves on either side of the prostate that are responsible for erection. If cancer is not nearby and these nerves can be spared, a careful surgeon takes extreme care to treat them gently. However, these nerves do not have the protective coating (the myelin sheath) that insulates larger nerves, and this makes them vulnerable to injury from heat and stretching. For this reason, says neuro-urologist Arthur Burnett, M.D., M.B.A., and The Patrick C. Walsh Professor of Urology, these nerves often take a hit simply because neighboring tissue is being removed – imagine windows shattering throughout a city block after a grenade goes off in a parked car. "It is evident that these nerves still sustain a ‘shock effect’ during surgery despite our best precautions," he says. "The result is that erection recovery after surgery is often delayed."
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