Nerve-Sparing Radical Prostatectomy

Surgery (radical prostatectomy) is one option for treating prostate cancer. Personally, since I was in my mid-50’s when prostate cancer was detected, I opted for this route. The two major risks posed by surgery and other treatments are incontinence and impotence.  The area surrounding the prostate gland is densely composed of small blood vessels and nerves which control urinary function and erections. The presence of numerous small blood vessels in the area surrounding the prostate make the surgical field a bloody one, hence the chances of severing an essential nerve(s) are increased. In the 1980’s, Dr. Patrick Walsh of Johns Hopkins Hospital in Baltimore, Maryland developed a surgical technique wherein sensitive nerves could be spared to a large degree, hence the term “nerve-sparing” prostatectomy. This technique is described in numerous on-line websites including the September 14th issue of the  Johns Hopkins Health Alerts. If you are considering having a radical prostatectomy either robotically or via the traditional surgical route, I highly suggest you seek out an experienced surgeon who has been specifically trained in the nerve-sparing technique and has performed many often thousands of these procedures successfully. One should also inquire about their success rates for maintaining erections and minimizing incontinence. From personal experience, I have found that an individual is “never quite the same” after most forms of treatment. Hence limiting any undesirable side effects is of maximum importance. While surgeons proficient in this technique are not limited to Johns Hopkins physicians, I have found numerous sites of interest by searching the internet using the term “nerve sparing prostatectomy, Johns Hopkins.”  or “nerve-sparing technique, prostate cancer.” There are also a series of videos depicting the surgery itself which illustrate the challenges and surgical prowess necessary to preserve urinary and erection-maintaining functions. Seeking the proper surgeon is the key to success. In my own case, upon my diagnosis in 1995, my first impulse was to contact Dr. Patrick Walsh at Johns Hopkins but when I sought God’s advice, He led me to one of Dr. Walsh’s colleagues, Dr. Jacek Mostwin, currently Professor  of Urology at John Hopkins Medicine. I can personally recommend him most highly. There are however many other skilled and experienced surgeons at fine hospitals and university centers. The reader is urged to seek them out and ask pertinent questions. God often treats and heals our infirmities through gifted physicians, a fact to which I can testify.

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