Want to avoid erectile dysfunction following prostate cancer surgery? Find an experienced, gentle surgeon

ScienceDaily (May 16, 2012) Prostate cancer is the most commonly diagnosed non-skin cancer in the U.S., and radical prostatectomy, the surgical removal of the prostate gland, remains the most popular therapeutic option, accounting for half of treatments.

The procedure, however, is not without possible side effects, primarily erectile dysfunction and incontinence. But a good nerve-sparing surgical technique can lessen the likelihood of these undesirable outcomes, as can the skill and experience of the surgeon, according to a new UCLA study that focused on robotic-assisted prostate surgery.

The study findings are published in the June 2012 print edition of the international peer-reviewed journal European Urology.

Based on their research, the study authors recommend that men undergoing robotic-assisted surgery for prostate cancer should look for a doctor who has performed at least 1,000 surgeries and who actively seeks to improve and enhance his/her surgical skills to help ensure a successful post-surgery recovery of erectile function.

The authors also found that new, refined techniques that prioritize the gentle handling of the delicate nerves around the prostate also make a difference in improved erectile function.

The study is one of the first to characterize a surgeons' learning curve for improving erectile-potency outcomes and to demonstrate and quantify gentler handling techniques that involve minimizing stretch injury to the nerves around the prostate as the gland is removed, the researchers said.

"It would be helpful for men who seek a surgical cure for their prostate cancer to appreciate the nuances required by a surgeon to successfully protect erectile function," said Dr. Jim Hu, director of minimally invasive surgery in the department of urology at the David Geffen School of Medicine at UCLA and lead author of the study. "Like improving a golf swing, a technique for nerve-sparing surgery has many subtleties that are influenced by training, talent, a desire to improve, and meticulous review of technique and outcomes."

The research team developed a video demonstrating the new techniques so that robotic-assisted surgeons may achieve better outcomes more quickly and potentially shorten their learning curves. Hu noted that the anatomic concepts and techniques extend to traditional, non-robotic-assisted surgery as well.

For the study, the team looked at nerve-sparing techniques and maneuvers used in the operating room in 400 surgeries performed by Hu over a two-year period at Brigham and Women's Hospital in Massachusetts. Hu tracked his patients' erectile-potency recovery outcomes by groups of 50 up to one year after surgery.

While this is a single-surgeon study during robotic-assisted surgery, Hu used standardized questionnaires to quantify patient-reported recovery of erectile function, which is not often done by individual surgeons and which helped in assessing outcomes.

Go here to read the rest:
Want to avoid erectile dysfunction following prostate cancer surgery? Find an experienced, gentle surgeon