Following the surgery, younger patients began to report that they were still sexually potent, which indicated that the nerves stimulating erectile function can be preserved. Unfortunately, a detailed anatomic description of the nerves could not be found in the literature. A major effort was launched by Dr. Walsh to modify the procedure to avoid the cavernous nerves while maintaining adequate surgical margins. A central task, undertaken by Dr. Lepor, was the painstaking effort to accurately chart the complex anatomy encompassing the prostate. This involved dissection and three dimensional reconstruction of the adult human pelvis in minute detail to determine precisely where the microscopic cavernous nerves are located.
Many men find the prospect of lifelong impotence devastating.
As a result, they may not select the most effective treatment. Dr. Lepor and colleagues presented the new discoveries about the pelvic anatomy, the cavernous nerves, and their location at the National Meeting of the American Urological Association in 1982. This research allowed Dr. Walsh, Dr. Lepor, and colleagues to refine the surgical techniques for preserving the nerves. These advances made it possible to greatly reduce the rates of impotence following radical prostatectomy for patients with localized prostatic cancer. However, knowledge of the anatomy and procedures alone is insufficient.