Nerve-sparing radical retropubic prostatectomy

Proper patient selection is crucial in evaluating the role of nerve-sparing radical prostatectomy. Nerve-sparing radical prostatectomy is a suitable option for patients with low-volume, low-grade tumors. In patients with high-grade or bulky tumors, the anatomic approach described by Walsh can and usually should be modified to provide wider excision of the neurovascular bundles than was previously achieved with the standard radical prostatectomy. The anatomic approach to radical retropubic prostatectomy, which allows for nerve-sparing, appears to be a reliable treatment for patients with organ-confined prostate cancer. The nerve-sparing procedure results in significantly less morbidity and fewer functional sacrifices than the standard radical prostatectomy.