Erectile dysfunction is one of the important morbidities following the radical prostatectomy (RP) surgeries. The goal of this research is to investigate the contribution of intraoperative neuromonitorisation method (IONM) on postoperative erectile function in patients who underwent robotic-assisted laparoscopic radical prostatectomy (RALP) with the localise prostate cancer (LPCa).
In this randomised controlled study contains 88 patients with LPCa were classified based on D'Amico Risk Classification. 61 patients who met the necessary criteria were divided into two groups as neuromonitorisation group (n = 30) and control group (n = 31). All patients were operated under general anaesthesia. All patients included in the study underwent RALP by robotic-assisted system. For the neuromonitorisation, IONM electromyography electrodes were placed to the right and left cavernous bodies in neuromonitorisation group. Impulses in the corpora cavernosa were considered significant. Postoperative erectile functions were determined according to the 3th and 6th month IIEF-5 scores. Demographic data, operative procedures, Gleason scores, final pathology, surgery border, PSA, and IIEF-5 score of patients were recorded.
No statistically difference was found between the groups in terms of demographic data, operative procedures, Gleason scores, final pathology, surgery border, and third-month PSA levels (p > 0.05). There was statistically difference between the postoperative third and 6-month IIEF-5 score in neuromonitorisation group (p < 0.05).
In the IONM technique, high rate of improvement in erectile function was observed in the early period thanks to personalised neuroprotective surgery applied to patients.
International urology and nephrology. 2019 Sep 23 [Epub ahead of print]
İbrahim Karabulut, Erkan Cem Çelik, Fatih Kürsat Yılmazel, Fatih Özkaya, Fevzi Bedir, Mustafa Ceylan, Onur Ceylan, Ali Haydar Yılmaz, Şenol Adanur
Department of Urology, Education and Research Hospital, Erzurum, Turkey., Department of Anesthesiolgy and Reanimation, Education and Research Hospital, Erzurum, Turkey., Medical Faculty, Department of Urology, Atatürk University, Erzurum, Turkey., Medical Faculty, Department of Neurology, Atatürk University, Erzurum, Turkey., Medical Faculty, Department of Pathology, Atatürk University, Erzurum, Turkey., Department of Urology, Bilecik State Hospital, Bilecik, Turkey. .