Proposal of a method to assess and report the extent of residual neurovascular tissue present in radical prostatectomy specimens

Oscar Schatloff, Darian Kameh, Camilo Giedelman, Srinivas Samavedi, Haidar Abdul-Muhsin, Rafael F. Coelho, Sung Gu Kang, Kenneth J. Palmer, Vipul R. Patel

    Research output: Contribution to journalArticlepeer-review

    3 Citations (Scopus)

    Abstract

    Objective To propose a method to assess and report the amount of neurovascular tissue present in radical prostatectomy (RP) specimens. Patients and Methods The data of 133 consecutive patients who underwent robot-assisted RP by a single surgeon (V.R.P.) were prospectively collected. Degree of nerve sparing (NS) was graded intraoperatively by the surgeon independently at either side as complete, partial or none. A pathologist who was 'blinded' to the surgeon's classification measured the following parameters at the posterolateral aspect of the apex, base and mid prostate at either side of the RP specimen: length, width and area of neural tissue, number of nerves per high-power field and number of total slides containing neural tissue. Measurements were correlated to the surgeon's intraoperative perception. Results All measurements correlated significantly with surgeon's intent of NS at all locations (P = 0.001). Among them, the cross-sectional area had the highest correlation coefficient (-0.550 at apex, -0.604 at mid prostate and -0.606 at the base). Conclusions The cross-sectional area of nerve tissue showed the highest correlation with surgeon's intent of NS at all locations. Having a standardised method of assessing and reporting residual nerve tissue allows the surgeon to objectively evaluate the quality of nerve preservation and to compare the progress of his NS technique over time.

    Original languageEnglish
    Pages (from-to)E301-E306
    JournalBJU International
    Volume112
    Issue number4
    DOIs
    Publication statusPublished - 2013 Aug

    Keywords

    • cavernous nerves
    • nerve sparing
    • neurovascular bundle
    • robot-assisted radical prostatectomy

    ASJC Scopus subject areas

    • Urology

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