Lead author Dr. Jim Hu, director of minimally invasive surgery in the department of urology at the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues recommend that men undergoing robotic-assisted surgery for prostate removal should look for a doctor who has performed at least 1,000 surgeries.
"It would be helpful for men who seek a surgical cure for their prostate cancer to appreciate the nuances required by a surgeon to successfully protect erectile function," Hu said in a statement. "Like improving a golf swing, a technique for nerve-sparing surgery has many subtleties that are influenced by training, talent, a desire to improve, and meticulous review of technique and outcomes."
The research team looked at nerve-sparing techniques and maneuvers used in the operating room in 400 surgeries performed by Hu over a two-year period at Brigham and Women's Hospital in Boston. Hu tracked his patients' erectile-potency recovery outcomes up to one year after surgery.
The study, scheduled to be published in the journal European Urology, found greater surgeon experience and more delicate handling of the nerves to minimize stretch injury helped improve erectile function significantly.
At five months post-operatively, patients went from zero to as high as 33 percent in erectile-function recovery and at 12 months post-operatively, they went from 15 percent to as high as 59 percent.