Nerve grafts may restore erectile function

In men who have become impotent following prostate cancer surgery, implantation of nerve grafts into the penis allows some men who were potent before surgery to recover erectile function, researchers report.

The findings come from a study that reviewed the records of 44 consecutive patients who underwent implantation of two grafts after treatment for prostate cancer at Memorial Sloan-Kettering Cancer Center in New York.

The overall five-year recovery rate of erectile function, which was defined as erections satisfactory for intercourse with or without oral medication, was 34 percent and the rate of consistent penetration was 11 percent, report Dr. Fernando P. Secin and his associates in The Journal of Urology.

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The researchers used the sural nerve (also called the small saphenous nerve), which supplies the skin on the back of the leg and is considered the “gold standard.” They also used the genitofemoral nerve, which passes through the lower back, based on the success reported in earlier studies and the fact that it is easy to remove and associated with few complications.

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The researchers found no “statistically significant difference in erectile function recovery or the achievement of clinically meaningful erections using sural nerve grafts compared to genitofemoral nerves.”

Based on their experience, Secin and colleagues think bilateral cavernous nerve grafts might be beneficial in select patients. However, this still depends on the outcome of larger, optimally designed studies.