Robotic Radical Prostatectomy with the “Veil of Aphrodite” Technique: Histologic Evidence of Enhanced Nerve Sparing

Savera, Adnan T.; Kaul, Sanjeev; Badani, Ketan K.; Stark, Azadeh; Shah, Nikhil; Menon, Mani

doi:10.1016/j.eururo.2006.02.050

Cited by 154 publications

(98 citation statements)

References 23 publications

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“…Considerable debate has developed over novel nervesparing modifications such as the 'Veil of Aphrodite' te ch ni que [30]. The 'standard' technique releases the neurovascular bundle from the posterolateral groove in the inter-fascial plane.…”

Section: Potency Outcomementioning

confidence: 99%

Outcomes after robot-assisted laparoscopic radical prostatectomy

Murphy¹,

Challacombe²,

Costello³

2008

Asian J Androl

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Section: Potency Outcomementioning

confidence: 99%

Outcomes after robot-assisted laparoscopic radical prostatectomy

Murphy¹,

Challacombe²,

Costello³

2008

Asian J Androl

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“…The "Veil of Mystery" technique with preservation of the prostatic fascia seems to reduce significantly the number of nerves present on the specimen, offering consistent quantitative data as a good nerve-sparing technique (15). Furthermore, Takena et al showed that preservation of the puboprostatic collar and puboperineoplasty contributed to the early recovery of urinary continence after robotic-assisted RP (14).…”

Section: Commentsmentioning

confidence: 99%

“…The fibers of the external urinary sphincter originate dorsally from a point very near the bladder neck and lie on the anterolateral of the urethra in a horseshoe shape ending even with the prostatic apex (14). Previous studies demonstrated that there is a direct relation between protecting surgical anatomic structures (e.g., puboprostatic ligament, sphincter, and periprostatic fascias) and continence rates while performing RPs (6,15).…”

Section: Commentsmentioning

confidence: 99%

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Radical perineal prostatectomy and early continence: outcomes after 120 cases

Albayrak¹,

Cangüven²,

Göktaş³

et al. 2010

Int. braz j urol.

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Purpose: Evaluate the results of urinary continence on patients who had undergone radical perineal prostatectomy (RPP) for clinically localized prostate cancer. Materials and Methods:We analyzed the continence data of 120 patients with pathology of cT1-cT2N0M0 prostate cancer and who had undergone RPP. Continence was assessed on the day of catheter removal, at the end of the first and third month, and the first year postoperatively. The patients who were continent immediately after catheter removal were classified in the group of "immediately continent" while the patients who became continent during the 3 postoperative months were classified as "early continent." Results: Mean duration of catheterization was 10 (10-25) days. Of 120 patients, 44 (36.7%) were immediately continent. At the end of the first and third months, 65 (54.1%) and 87 (72.5%), respectively, were early continent. At the one-year follow-up, 95.3% of 107 cases whose one-year follow-up data were available were continent. When the relationship between patients' age and continence was analyzed, it was found that the early continence rates were 77.7% (7/9), 73.3% (33/45), 73.4% (36/49), and 64.7% (11/17) in the groups of ≤ 49, 50-59, 60-69, and ≥ 70 years, respectively (p = 0.68). Conclusions: The majority of patients who underwent RPP rapidly regained continence within 3 months. RPP is an exceptional alternative approach for radical surgery in the treatment of localized prostate cancer.

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“…8,9 Furthermore, anatomical and electrophysiological studies showed the distribution of nerve fibers on the ventral side of the prostatic fascia. [10][11][12][13][14] However, all of these anatomic and electrophysiological papers showed interindividual variations. Since 2000, we have used a laparoscopic approach for radical prostatectomy.…”

Section: Introductionmentioning

confidence: 99%

Classification of the distribution of cavernous nerve fibers around the prostate by intraoperative electrical stimulation during laparoscopic radical prostatectomy

et al. 2011

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We investigated the distribution of cavernous nerve (CN) fibers around the prostate by electrical nerve stimulation during laparoscopic radical prostatectomy to classify the distribution of the CN fibers. Electrical stimulation was performed on 30 consecutive patients with localized prostate cancer; middle of the neurovascular bundle (NVB, point A), base of the NVB (point B), the rectal wall 1 cm posterolateral to the NVB (point C) and the lateral aspect of the prostate (point D). We measured the intraurethral pressure at the midportion to detect the changes in intracavernosal pressure. The mean maximum changes were 10.5 ± 7.9, 11.6 ± 8.8, 9.6 ± 7.4 and 6.7 ± 7.0 cm H 2 O at points A, B, C and D, respectively. The patterns of CN fiber distribution were divided into four groups: type 1 (23%), the bundle corresponding to the NVB; type 2 (7%), the bundle from the rectal wall to the prostate; type 3 (27%), the plate including NVB and posterolateral to NVB; and type 4 (43%), the plate between the rectal wall posterolateral to the NVB and the lateral aspect of the prostate. Distribution of the CNs in a bundle-like formation was considered to account for 30%, whereas a plate-like formation accounted for 70%. Understanding these four patterns of CN fiber distribution should facilitate accurate CN-sparing radical prostatectomy.

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Robotic Radical Prostatectomy with the “Veil of Aphrodite” Technique: Histologic Evidence of Enhanced Nerve Sparing

Cited by 154 publications

References 23 publications

Outcomes after robot-assisted laparoscopic radical prostatectomy

Outcomes after robot-assisted laparoscopic radical prostatectomy

Radical perineal prostatectomy and early continence: outcomes after 120 cases

Classification of the distribution of cavernous nerve fibers around the prostate by intraoperative electrical stimulation during laparoscopic radical prostatectomy

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