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Penile reinnervation in the treatment of iatrogenic erectile dysfunction in patients after radical prostatectomy DOI: 10.29188/2222-8543-2025-18-1-84-89
- Gural A.K. – urologist, Regional State Autonomous Healthcare Institution – Tomsk Regional Oncologic Dispensary; Tomsk, Russia; RSCI Author ID 1246218, https://orcid.org/0000-0002-0454-7930
- Kyzlasov P.S. – Dr. Sci., Professor, Head of the Center of Urology and Andrology A.I. Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency; Moscow, Russia; RSCI Author ID 615093, https://orcid.org/0000-0003-1050-6198
- Mustafaev A.T. – PhD, urologist of the A.I. Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency; Moscow, Russia; RSCI Author ID 1087946, https://orcid.org/0000-0002-2422-7942
- Abuev G.G. – urologist, PhD-student of department of urology and andrology FMBC them A.I. Burnazyan FMBA of Russia; Moscow, Russia; RSCI Author ID 1181193, https://orcid.org/0000-0001-7749-0560
- Baytinger V.F. – Dr. Sci., Professor, President of the Institute of Microsurgery; Professor, the Department of Operative Surgery and Topographic Anatomy, Krasnoyarsk State Medical University named after Prof. V.F. Voyno-Yasenetsky; Tomsk, Russia;RSCI Author ID 98084, https://orcid.org/0000-0002-7754-7472
- Baytinger A.V. – PhD, plastic surgeon, Institute of Microsurgery; Tomsk, Russia; RSCI Author ID 642209, https://orcid.org/0000-0002-7754-7472
- Boshchenko V.S. —Dr.Sci. Associate Professor; Professor of Department of General Urology and Pediatric Urology-andrology, Siberian State Medical University; Tomsk, Russia; RSCI Author ID 617922, https://orcid.org/0000-0002-2448-9870
478 Introduction. Radical prostatectomy (RP) remains the main, iatrogenic cause of erectile dysfunction (ED) and, despite the development and implementation of modern methods such as laparoscopy and robotic surgery, the relevance of ED after RP remains at a high level.
Objective. To evaluate the effectiveness of a new penile reinnervation method using a n. suralis graft with distal fraying and end-to-side neuroraphy between the motor fasciculus of the femoral nerve and the cavernous body in patients undergoing RP.
Materials and methods. 16 patients with an average age of 60,4 years who underwent RP were included in the study. All patients had satisfactory sexual activity before surgery. After RP all patients underwent penile reinnervation, including end-to-side neuroraphy between the femoral nerve and the sural nerve, as well as penile graft implantation into the cavernous bodies. Prior to the procedure, patients underwent preliminary assessments of sexual function.
Results. After penile reinnervation, a significant improvement in erectile function was observed in all patients. The assessment of sexual function using the IIEF-5 questionnaire showed an improvement in the average value from 5 to 16 points. In addition, the occurrence of spontaneous tumescence in all patients at night was noted.
Conclusions. Reinnervation of the penis using n. suralis graft and end-to-side neuroraphy can be an effective method of restoring erectile function in patients after RP. Further studies with larger patient samples are needed to confirm the results and optimize this procedure.
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