Current view on nerve-sparing radical prostatectomy
https://doi.org/10.17650/1726-9776-2019-15-3-17-27
Abstract
More than 35 years since the first deliberate nerve-sparing radical prostatectomy, this technique remains one of the main methods of treatment for patients with localized prostate cancer. Further study of operative anatomy of the lower pelvis and development of surgical technique facilitated evolution of approaches to nerve sparing. This review is dedicated to analysis of current approaches to preservation of neurovascular bundles in radical prostatectomy allowing to optimize functional results of surgical treatment of prostate cancer.
About the Authors
E. A. SokolovRussian Federation
Department of Urology and Surgical AndrologyRussian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
Build. 1, 2/1 Barrikadnaya St., Moscow 125993,
5 2nd Botkinskiy Proezd, Moscow 125284
Competing Interests: отсутствие конфликта интересов
E. I. Veliev
Russian Federation
Department of Urology and Surgical AndrologyRussian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
Build. 1, 2/1 Barrikadnaya St., Moscow 125993,
5 2nd Botkinskiy Proezd, Moscow 125284
Competing Interests: отсутствие конфликта интересов
R. A. Veliev
Russian Federation
Department of Urology and Surgical Andrology
Build. 1, 2/1 Barrikadnaya St., Moscow 125993
Competing Interests: отсутствие конфликта интересов
References
1. Salischev E.G. Full ablation of the prostate with lower parts of the seminal vesicles and two lower thirds of the rectum in their cancer. Khirurgicheskaya letopis = Surgical Annals 1895;5–6:885–99. (In Russ.).
2. Young H.H. Conservative perineal prostatectomy: the results of two years experience and report of seventy-five cases. Ann Surg 1905;41(4):549–57.
3. Memmelaar J. Total prostatovesiculectomy – retropubic approach. J Urol 1949;62(3):340–8.
4. Millin T. Retropubic prostatectomy. J Urol 1948;59(3):267–80.
5. Kopecky A.A., Laskowski T.Z., Scott R. Jr. Radical retropubic prostatectomy in the treatment of prostatic carcinoma. J Urol 1970;103(5):641–4.
6. Veenema R.J., Gursel E.O., Lattimer J.K. Radical retropubic prostatectomy for cancer: a 20-year experience. J Urol 1977;117(3):330–1.
7. Del Regato J.A. Radiotherapy in the conservative treatment of operable and locally inoperable carcinoma of the prostate. Radiology 1967;88(4):761–6. DOI: 10.1148/88.4.761.
8. Huggins C.B., Scott W.W. Bilateral adrenalectomy in prostatic cancer: clinical features and urinary excretion of 17-ketosteroids and estrogen. Ann Surg 1945;122(6):1031–41.
9. Walsh P.C. The discovery of the cavernous nerves and development of nerve sparing radical retropubic prostatectomy. J Urol 2007;177(5):1632–5. DOI: 10.1016/j.juro.2007.01.012.
10. Mullins J.K., Feng Z., Trock B.J. et al. The impact of anatomical radical retropubic prostatectomy on cancer control: the 30-year anniversary. J Urol 2012(6);188(6):2219–24. DOI: 10.1016/j.juro.2012.08.028.
11. Mottet N., Bellmunt J., Bolla M. et al. EAU-ESTRO-SIOG guidelines on prostate cancer. Part 1: Screening, diagnosis, and local treatment with curative intent. Eur Urol 2017;71(4):618–29. DOI: 10.1016/j.eururo.2016.08.003.
12. Rasner P.I., Kotenko D.V., Prilepskaya E.A. et al. Functional results of radical retropubic and robot-assisted prostatectomy in patients with localized prostate cancer. Vestnik Natsional’nogo mediko-khirurgicheskogo tsentra im. N.I. Pirogova = Bulletin of Pirogov National Medical and Surgical Center 2015;10(1):78–83. (In Russ.).
13. Walz J., Burnett A.L., Costello A.J. et al. A critical analysis of the current knowledge of surgical anatomy related to optimization of cancer control and preservation of continence and erection in candidates for radical prostatectomy. Eur Urol 2010;57(2):179–92. DOI: 10.1016/j.eururo.2009.11.009.
14. Walz J., Epstein J.I., Ganzer R. et al. A critical analysis of the current knowledge of surgical anatomy related to optimization of cancer control and preservation of continence and erection in candidates for radical prostatectomy. Eur Urol 2016;70(2):301–11. DOI: 10.1016/j.eururo.2016.01.026.
15. Stolzenburg J.U., Schwalenberg T., Horn L.C. et al. Anatomical landmarks of radical prostatectomy. Eur Urol 2007;51(3): 629–39. DOI: 10.1016/j.eururo. 2006.11.012.
16. Tewari A., Peabody J.O., Fischer M. et al. An operative and anatomic study to help in nerve sparing during laparoscopic and robotic radical prostatectomy. Eur Urol 2003;43(5):444–54.
17. Graefen M., Walz J., Huland H. Open retropubic nerve-sparing radical prostatectomy. Eur Urol 2006;49(1):38–48. DOI: 10.1016/j.eururo.2005.10.008.
18. Secin F.P., Serio A., Bianco F.J. Jr et al. Preoperative and intraoperative risk factors for side-specific positive surgical margins in laparoscopic radical prostatectomy for prostate cancer. Eur Urol 2007;51(3): 764–71. DOI: 10.1016/j.eururo.2006.10.058.
19. Nielsen M.E., Schaeffer E.M., Marschke P., Walsh P.C. High anterior release if the levator fascia improves sexual function following open radical retropubic prostatectomy. J Urol 2008;180(6):2557–64. DOI: 10.1016/j.juro.2008.08.047.
20. Muraoka K., Hinata N., Morizane S. et al. Site-dependent and inter-individual variations in Denonvilliers’ fascia: a histological study using donated elderly male cadavers. BMC Urol 2015;15:42. DOI: 10.1186/s12894-015-0034-5.
21. Villers A., Stamey T.A., Yemoto C. et al. Modified extrafascial radical retropubic prostatectomy technique decreases frequency of positive surgical margins in T2 cancer <2 cm(3). Eur Urol 2000;38(1): 64–73. DOI: 10.1159/000020254.
22. Lunacek A., Schwentner C., Fritsch H. et al. Anatomical radical retropubic prostatectomy: “curtain dissection” of the neurovascular bundle. BJU Int 2005;95(9):1226–31. DOI: 10.1111/j.1464-410X.2005.05510.x.
23. Eichelberg C., Erbersdobler A., Michl U. et al. Nerve distribution along the prostatic capsule. Eur Urol 2007;51(1):105–10. DOI: 10.1016/j.eururo.2006.05.038.
24. Alsaid B., Bessede T., Diallo D. et al. Division of autonomic nerves within the neurovascular bundles distally into corpora cavernosa and corpus spongiosum components: immunohistochemical confirmation with three-dimensional reconstruction. Eur Urol 2011;59(6):902–9. DOI: 10.1016/j.eururo.2011.02.31.
25. Ganzer R., Stolzenbrug J.U., Wieland W.F., Bründl J. Anatomic study of periprostatic nerve distribution: immunohistochemical differentiation of parasympathetic and sympathetic nerve fibres. Eur Urol 2012;62(6):1150–6. DOI: 10.1016/j.eururo.2012.03.039.
26. Costello A.J., Dowdle B.W., Namdarian B. et al. Immunohistochemical study of the cavernous nerves in the periprostatic region. BJU Int 2011;107(8):1210–5. DOI: 10.1111/j.1464.-410X.2010.09711.x.
27. Tewari A., Takenaka A., Mtui E. et al. The proximal neurovascular plate and the trizonal neural architecture around the prostate gland: importance in the athermal robotic technique of nerve sparing prostatectomy. BJU Int 2006;98(2):314–23. DOI: 10.1111/j.1464-410X.2006.06266.x.
28. Park B.J., Kim M.J., Whang S.Y. et al. Preoperative detection and localization of accessory pudendal artery with contrast. Radiology 2012;262(3):903–11. DOI: 10.1148/radiol.11110934.
29. Henry B.M., Pekala P.A., Vikse J. et al. Variations in the arterial blood supply to the penis and the accessory pudendal artery: a meta-analysis and review of implications in radical prostatectomy. J Urol 2017;198(2):345–53. DOI: 10.1016/j.juro.2017.01.080.
30. Menon M., Shrivastava A., Bhandari M. et al. Vattikuti institute prostatectomy: technical modifications in 2009. Eur Urol 2009;56(1):89–96. DOI: 10.1016/j.eururo.2009.04.032.
31. Park Y.H., Jeong C.W., Lee S.E. A comprehensive review of neuroanatomy of the prostate. Prostate Int 2013;1(4): 139–45. DOI: 10.12954/PI.13020.
32. Lim S.K., Kim K.H., Shin T.Y. et al. Retzius-sparing robot-assisted laparoscopic radical prostatectomy: combining the best of retropubic and perineal approaches. BJU Int 2014;114(2):236–44. DOI: 10.1111/bju.12705.
33. Pisipati S., Ali A., Mandalapu R.S. et al. Newer concepts in neural anatomy and neurovascular preservation in robotic radical prostatectomy. Indian J Urol 2014;30(4):399–409. DOI: 10.4103/09701591.142064.
34. Ganzer R., Stolzenburg J.U., Neuhaus J. et al. Anatomical study of pelvic nerves in relation to seminal vesicles, prostate and urethral sphincter: immunohistochemical staining, computerized planimetry and 3-dimensional reconstruction. J Urol 2015;193(4):1205–12. DOI: 10.1016/j.juro.2014.10.001.
35. Gilbert S.M., Dunn R.L., Miller D.C. et al. Functional outcomes following nerve sparing prostatectomy augmented with seminal vesicle sparing compared to standard nerve sparing prostatectomy: results from randomized controlled trial. J Urol 2017;198(3):600–7. DOI: 10.1016/j.juro.2017.03.133.
36. Huri E. Novel anatomical identification of nerve-sparing radical prostatectomy: fascial-sparing radical prostatectomy. Prostate Int 2014;2(1):1–7. DOI: 10.12954/PI.13038.
37. Montorsi F., Wilson T.G., Rosen R.C. et al. Best practices in robot-assisted radical prostatectomy: recommendations of the Pasadena consensus panel. Eur Urol 2012;62(3):368–81. DOI: 10.1016/j.eururo.2012.05.057.
38. Tewari A.K., Srivastava A., Huang M.W. et al. Anatomical grades of nerve sparing: a risk-stratified approach to neural-hammock sparing during robotic-assisted radical prostatectomy (RARP). BJU Int 2011;108(6):984–92. DOI: 10.1111/j.1464-410X.2011.10565.x.
39. Schatloff O., Chauhan S., Silverman A. et al. Anatomic grading of nerve sparing during robot-assisted radical prostatectomy. Eur Urol 2012;61(4):796–802. DOI: 10.1016/j.eururo.2011.12.048.
40. Nguyen L.N., Head L., Witiuk K. et al. The risks and benefits of cavernous neurovascular bundle sparing during radical prostatectomy: a systematic review and meta-analysis. J Urol 2017;198(4):760–9. DOI: 10.1016/j.juro.2017.02.3344.
41. Menon M., Dalela D., Jamil M. et al. Functional recovery, oncologic outcomes and postoperative complications after robotassisted radical prostatectomy: an evidencebased analysis comparing the retzius sparing and standard approaches. J Urol 2018;199(5):1210–7. DOI: 10.1016/j.juro.2017.11.115.
42. Coughlin G.D., Yaxley J.W., Chambers S.K. et al. Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: 24-month outcomes from a randomised controlled study. Lancet 2018;19(8):1051–60. DOI: 10.1016/S14702045(18)30357-7.
43. Veliev E.I., Golubtsova E.N., Kotov S.V. Dynamics of urine retention restoration in patients after retropubic nerve-sparing radical prostatectomy. Onkourologia = Cancer Urology 2011;(2):52–5. (In Russ.).
44. Rasner P.I. Selection of surgical treatment for localized prostate cancer. Thesis … of doctor of medical science, 14.01.23. Moscow, 2016. 299 p. (In Russ.).
45. Avulova S., Zhao Z., Lee D. et al. The effect of nerve sparing status on sexual and urinary function: 3-year results from CAESAR study. J Urol 2018;199(5):1202–09. DOI: 10.1016/j.juro.2017.12.037.
46. Kumar A., Samavedi S., Bates A.S. et al. Safety of selective nerve sparing in high risk prostate cancer during robot-assisted radical prostatectomy. J Robotic Surg 2017;11(2):129–38. DOI: 10.1007/s11701016-0627-3.
47. Martini A., Gupta A., Lewis S.C. et al. Development and internal validation of a side-specific, multiparametric magnetic resonance imaging-based nomogram for the prediction of extracapsular extension of prostate cancer. BJU Int 2018;122(6):1025–33. DOI: 10.1111/bju.14353.
48. Mirmilstein G., Rai B.P., Gbolahan O. et al. The neurovascular structure-adjacent frozen-section examination (NeuroSAFE) approach to nerve sparing in robot-assisted laparoscopic radical prostatectomy in a British setting – a prospective observational comparative study. BJU Int 2018;121(6): 854–62. DOI: 10.1111/bju.14078.
49. Mangano M.S., De Gobbi A., Beniamin F. et al. Robot-assisted nerve-sparing radical prostatectomy using near-infrared fluorescence technology and indocyanine green: initial experience. Urologiia 2018;85(1):29–31. DOI: 10.5301/uj.5000244.
50. Yoon Y., Jeon S.H., Park Y.H. et al. Visualization of prostatic nerves by polarizationsensitive optical coherence tomography. Biomed Opt Express 2016;7(9):3170–83. DOI: 10.1364/BOE.7.003170.
Review
For citations:
Sokolov E.A., Veliev E.I., Veliev R.A. Current view on nerve-sparing radical prostatectomy. Cancer Urology. 2019;15(3):17-27. (In Russ.) https://doi.org/10.17650/1726-9776-2019-15-3-17-27