Thermal Sensation Spared in Nerve-Sparing Prostatectomy

Findings suggest that thermal sensation may indicate damage to cavernous nerves

THURSDAY, Sept. 13 (HealthDay News) -- Penile thermal sensory thresholds increase after non-nerve-sparing radical prostatectomy (RP) but not after the nerve-sparing procedure, according to a study published in the September issue of The Journal of Sexual Medicine.

René Yiou, M.D., Ph.D., from the Hôpital Henri Mondor in Paris, and colleagues examined the value of penile thermal and vibratory sensory thresholds to reflect cavernous nerve damage caused by RP. Participants included 42 consecutive patients undergoing RP with cavernous nerve sparing (laparoscopic approach, 12 patients) or without cavernous nerve sparing (laparoscopic approach, 13 patients; retropubic approach, 11 patients; transperineal approach, six patients). One month before and two months after RP, penile thermal and vibratory sensory thresholds were measured along with Erectile Dysfunction Symptom Score (EDSS).

The researchers found that penile sensory thresholds for warm and cold sensations increased significantly after non-nerve-sparing RP, but not after nerve-sparing RP. Only after transperineal non-nerve sparing did vibration threshold increase significantly. Two months after surgery, EDSS values were significantly increased in all groups of patients.

"In this series, postoperative changes in penile sensory thresholds differed with the surgical technique of RP, as the cavernous nerves were preserved or not," the authors write. "The present results support the value of quantitative penile sensory threshold measurement to indicate RP-induced cavernous nerve injury."

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