Impotence Following Radical Prostatectomy: Insight Into Etiology and Prevention (1982)

No AccessJournal of Urology1 Sep 1982Impotence Following Radical Prostatectomy: Insight Into Etiology and Prevention Patrick C. Walsh, and Pieter J. Donker Patrick C. WalshPatrick C. Walsh More articles by this author , and Pieter J. DonkerPieter J. Donker More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)53012-8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail This study was undertaken to identify the cause of impotence in men undergoing radical prostatectomy, with the hope that this information may provide insight into the possible prevention of this complication. The autonomic innervation of the corpora cavernosa in the male fetus and newborn was traced to determine the topographical relationship between the pelvic nerve plexus, and the prostate, urethra and urogenital diaphragm. We have demonstrated that the branches of the pelvic plexus that innervate the corpora cavernosa are situated between the rectum and urethra, and penetrate the urogenital diaphragm near or in the muscular wall of the urethra. Injuries to the pelvic plexus can occur in 2 ways: 1) during division of the lateral pedicle and 2) at the time of apical dissection with transection of the urethra. Thirty-one men who underwent radical retropubic prostatectomy were evaluated to determine risk factors that correlated with postoperative impotence: 5 (16 per cent) were fully potent, 7 (23 per cent) had partial erections that were inadequate for sexual intercourse and 19 (61 per cent) had total erectile impotence. The 2 factors that had a favorable influence on postoperative potency were age and pathologic stage of the lesion: 31 per cent of the patients less than 60 years old were potent versus only 6 per cent of the patients more than 60 years, while 33 per cent of the patients with tumor microscopically confined to the prostatic capsule were potent versus only 5 per cent of those with capsular penetration. When the factors of age and capsular penetration were combined 60 per cent of the men less than 60 years old who had an intact prostatic capsule were potent. Arterial insufficiency and psychogenic factors were excluded as major contributing factors by the finding of normal penile blood flow and absence of nocturnal penile tumescence in the impotent patients. We conclude that impotence after radical prostatectomy results from injury to the pelvic nerve plexus that provides autonomic innervation to the corpora cavernosa. Further studies will be necessary to determine whether refinements in surgical technique, especially during ligation of the lateral pedicle and apical dissection, can prevent this complication. © 1982 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByAvulova S, Zhao Z, Lee D, Huang L, Koyama T, Hoffman K, Conwill R, Wu X, Chen V, Cooperberg M, Goodman M, Greenfield S, Hamilton A, Hashibe M, Paddock L, Stroup A, Resnick M, Penson D and Barocas D (2018) The Effect of Nerve Sparing Status on Sexual and Urinary Function: 3-Year Results from the CEASAR StudyJournal of Urology, VOL. 199, NO. 5, (1202-1209), Online publication date: 1-May-2018.Lundgren P, Kjellman A, Norming U and Gustafsson O (2018) Long-Term Outcome of a Single Intervention Population Based Prostate Cancer Screening StudyJournal of Urology, VOL. 200, NO. 1, (82-88), Online publication date: 1-Jul-2018.Lepor H (2016) Surgical Treatment of Prostate CarcinomaJournal of 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Prospective Study Measuring Penile Length in Men Treated With Radical Prostatectomy for Prostate CancerJournal of Urology, VOL. 169, NO. 4, (1462-1464), Online publication date: 1-Apr-2003.GUILLONNEAU B, H, H, X, J, G and G (2018) Laparoscopic Radical Prostatectomy: Oncological Evaluation After at Montsouris of Urology, VOL. 169, NO. 4, Online publication date: C, J, McGUIRE E, G and J (2018) Intraoperative Nerve Stimulation With Measurement of Urethral During Radical Retropubic Prostatectomy: A of Urology, VOL. 169, NO. 6, Online publication date: H, D, K and K (2018) Analysis and of in in a Prostatectomy of Erectile of Urology, VOL. NO. 1, Online publication date: P, F, A, M, E, G and B (2018) an for Intracavernous Following Sparing Radical Results From a Prospective StudyJournal of Urology, VOL. 169, NO. 6, Online publication date: L, P and (2018) Radical ProstatectomyJournal of Urology, VOL. NO. 1, Online publication date: J, R, J, N, R, W and R (2018) AFTER RADICAL PROSTATECTOMY: AND THE OF of Urology, VOL. NO. 3, Online publication date: J, P, A, G and N (2018) TO THE FOR PROSTATE of Urology, VOL. NO. 2 Part 1, Online publication date: G, H, X, H, G and GUILLONNEAU B (2018) Cystectomy with Prostate Sparing for Bladder Cancer in of Urology, VOL. NO. 6, Online publication date: J and R (2018) PROSTATIC of Urology, VOL. NO. 4, Online publication date: M, PARTIN A, PIANTADOSI S, EPSTEIN J and WALSH P (2018) SURVIVAL FOLLOWING RADICAL PROSTATECTOMY FOR PROSTATE of Urology, VOL. NO. 2, Online publication date: G, R, S, A and R (2018) RADICAL PROSTATECTOMY: OF of Urology, VOL. NO. 2, Online publication date: Y, W, LI Y and (2018) PENILE THE of Urology, VOL. NO. 1, Online publication date: J, M and J (2018) OF RESULTS OF CAVERNOUS NERVE RADICAL PROSTATECTOMYJournal of Urology, VOL. NO. 1, Online publication date: T, J, M, W and R (2018) THE OF IN FOR PROSTATE of Urology, VOL. NO. 2, Online publication date: R, J and N (2018) PENILE AFTER FOR OF PROSTATE of Urology, VOL. NO. 2, Online publication date: L, J, M, J, N, and M (2018) A OF CAVERNOUS NERVE PENILE TO NERVE SPARING RADICAL PROSTATECTOMYJournal of Urology, VOL. NO. 5, Online publication date: P (2018) RADICAL PROSTATECTOMY FOR PROSTATE CANCER CANCER OF A of Urology, VOL. NO. 6, Online publication date: N, M, T and H (2018) THE OF IN RADICAL RETROPUBIC PROSTATECTOMYJournal of Urology, VOL. NO. 3, Online publication date: A, N and J (2018) THE OF AND RADICAL PROSTATECTOMY of Urology, VOL. NO. 2, Online publication date: P, C and H (2018) AND OF THE AND IN AND of Urology, VOL. NO. 2, Online publication date: C, G, D, D and CATALONA W (2018) OF RADICAL RETROPUBIC PROSTATECTOMY FOR PROSTATE of Urology, VOL. NO. 4, Online publication date: J, R, H, B and K (2018) RADICAL of Urology, VOL. NO. 2, Online publication date: S, A, G, P, A and F (2018) OF THE OF IN of Urology, VOL. NO. 6, Online publication date: U, R and H (2018) OF of Urology, VOL. NO. 5, Online publication date: W, G, D and D (2018) POTENCY, CONTINENCE AND RATES IN CONSECUTIVE RADICAL RETROPUBIC PROSTATECTOMIESJournal of Urology, VOL. NO. 2, Online publication date: H, F, G, K, A and G (2018) TRANSURETHRAL OF AND OF THE OF THE MALE of Urology, VOL. NO. 1, Online publication date: P (2018) RADICAL PROSTATECTOMYJournal of Urology, VOL. NO. 6 Part 2, Online publication date: G, E and T (2018) OF PENILE AFTER CAVERNOUS NERVE IN of Urology, VOL. NO. 5, Online publication date: R, M, I, F, W, R, K, J, P, K and N (2018) AND OF TRANSURETHRAL IN FOLLOWING RADICAL PROSTATECTOMYJournal of Urology, VOL. NO. 4, Online publication date: M, F, A, W and K (2018) IN PROSTATE CANCER to FROM THE AND RESULTS of Urology, VOL. NO. Part 1, Online publication date: H, J, C and R (2018) ANATOMICAL AND of Urology, VOL. NO. 6, Online publication date: N and BRENDLER C (2018) OF RADICAL RETROPUBIC PROSTATECTOMY TO OF of Urology, VOL. NO. 4, Online publication date: G, G and BRENDLER C (2018) ANALYSIS OF FOR PROSTATE of Urology, VOL. NO. 5, Online publication date: L, M, R, A, M, G, Y, C and R (2018) in the After Penile of Urology, VOL. NO. 2, Online publication date: T, J, F, and E (2018) Nerve Distribution to the Urethra and Bladder in the of Urinary of Urology, VOL. NO. 3, Online publication date: F, G, L, L, Nava L, L, Rigatti P, G and A (2018) OF AFTER RADICAL RETROPUBIC PROSTATECTOMY AND EARLY INJECTIONS OF RESULTS OF A of Urology, VOL. NO. 4, Online publication date: G, M and S (2018) of Radical Prostatectomy and After the of Prostate Specific of Urology, VOL. NO. 6, Online publication date: J (2018) Fascial of the After Radical ProstatectomyJournal of Urology, VOL. NO. 3, Online publication date: O, K, A, S, G and G (2018) Urethral Surgical and Long-Term ResultsJournal of Urology, VOL. NO. 2, Online publication date: D, J, D, J, E, S, G and D (2018) The in Male of Urology, VOL. NO. 3, Online publication date: D and J (2018) in Radical Retropubic Prostatectomy: and of Urology, VOL. NO. 3, Online publication date: S, P, L, N, J and Lue T (2018) of Nerves After Cavernous Nerve in the of Urology, VOL. NO. 5, Online publication date: T, C, G, Carroll P and E (2018) Intraoperative Electrostimulation of Cavernous Results and of Urology, VOL. NO. 4, Online publication date: P, J and G (2018) is Nerve Sparing Radical Retropubic Prostatectomy?Journal of Urology, VOL. NO. 3, Online publication date: T and Walsh P (2018) Radical Retropubic Prostatectomy: The of Accessory Pudendal on the Recovery of Sexual of Urology, VOL. NO. 1, Online publication date: R (2018) Prostate of Urology, VOL. NO. 1, Online publication date: T, K, M and J (2018) The Effect of and on Urinary Function in With of Urology, VOL. NO. 1, Online publication date: E, D and K (2018) Prostatectomy Penile Assessment with of Urology, VOL. NO. 6 Part 2, Online publication date: P, A and Epstein J (2018) Cancer and Quality of Life Following Anatomical Radical Retropubic Prostatectomy: Results at of Urology, VOL. NO. 5 Part 2, Online publication date: M (2018) Measuring Quality of Life in Men with Prostate CancerJournal of Urology, VOL. NO. 5 Part 2, Online publication date: D, P, W and F (2018) Radical Prostatectomy as a for Locally Advanced Prostate CancerJournal of Urology, VOL. NO. 3, Online publication date: R, J, J and J (2018) The of Laparoscopic in with Radical or Retropubic ProstatectomyJournal of Urology, VOL. NO. 6, Online publication date: A, S, T, Epstein J, C, D, S and Walsh P (2018) Immunohistochemical of in the Autonomic Innervation of the of Urology, VOL. NO. 1, Online publication date: W and J (2018) of and Urinary Continence Following Nerve Sparing Radical Retropubic ProstatectomyJournal of Urology, VOL. NO. 3, Online publication date: J, J, R, R and R (2018) for Clinical a Cancer to of and Impact on of Urology, VOL. NO. 2, Online publication date: J and E (2018) of and of the of Urology, VOL. NO. 5 Part 1, Online publication date: R, S, E, J and Vickers M (2018) of Cavernous Nerves in the in of Erectile of Urology, VOL. NO. 1, Online publication date: C, H and J (2018) Magnetic Resonance Imaging of Urethral and Pelvic of Urology, VOL. NO. 4, Online publication date: P, G, J and J (2018) Radical retropubic and of with of Urology, VOL. NO. Part 2, Online publication date: M, R and J (2018) of After Radical Retropubic ProstatectomyJournal of Urology, VOL. NO. Part 2, Online publication date: J, R, D and Walsh P (2018) Nerve Nerve and Erectile Function in of Urology, VOL. NO. 2 Part 1, Online publication date: T (2018) This in of Erectile Function by Cavernous Nerve of Urology, VOL. NO. 2, Online publication date: D, R and Walsh P (2018) Cavernous Nerve Erectile Function in of Urology, VOL. NO. 2, Online publication date: M, R and Walsh P (2018) Impact of Anatomical Radical Prostatectomy on Urinary of Urology, VOL. NO. 3, Online publication date: A (2018) of Urology, VOL. NO. 3, Online publication date: D, Epstein J, B and Walsh P (2018) Sexual Function Radical Prostatectomy: of of Neurovascular of Urology, VOL. NO. 5, Online publication date: R, M and Walsh P (2018) Cancer Anatomical Radical Prostatectomy: An of Urology, VOL. NO. 6, Online publication date: C, P and Walsh P (2018) with of PotencyJournal of Urology, VOL. NO. 2 Part 1, Online publication date: J, R, R, R, J and G (2018) with of of Urology, VOL. NO. 2 Part 1, Online publication date: B, G, B, A and A (2018) of the Urinary on Development and Sexual Function in with of Urology, VOL. NO. 2 Part 2, Online publication date: C, G, F, J and Walsh P (2018) Recurrence and Following Radical of Urology, VOL. NO. 5, Online publication date: S, and W (2018) Role of Radical Prostatectomy for Clinical Prostate CancerJournal of Urology, VOL. NO. 6, Online publication date: M (2018) of Urology, VOL. NO. 2 Part 1, Online publication date: D (2018) of the Anterior for of Urology, VOL. NO. 2 Part 1, Online publication date: A, J, E, F and T (2018) The Role of in the of of Urology, VOL. NO. 3, Online publication date: P and B (2018) Continence Following Radical ProstatectomyJournal of Urology, VOL. NO. 5, Online publication date: J, S, B, Lue T and E (2018) of Penile Neurovascular Surgical of Urology, VOL. NO. 2, Online publication date: D, R, A, J and Walsh P (2018) The as a for the Study of Penile of Urology, VOL. NO. Part 1, Online publication date: and F (2018) Radical Prostatectomy: Surgical and ResultsJournal of Urology, VOL. NO. 3, Online publication date: R (2018) of of Urology, VOL. NO. 1, Online publication date: V, K and A (2018) Urethral after Radical Retropubic ProstatectomyJournal of Urology, VOL. NO. 2, Online publication date: R and W (2018) of Patients Following Radical ProstatectomyJournal of Urology, VOL. NO. 4, Online publication date: J (2018) An Urinary of Urology, VOL. NO. Part 1, Online publication date: P, Epstein J and F (2018) Potency Following Radical Prostatectomy with of the Neurovascular of Urology, VOL. NO. Part 1, Online publication date: E and H (2018) in Canine Insight into Development and of Urology, VOL. NO. Part 2, Online publication date: A (2018) Radical Prostatectomy for in Men More of Urology, VOL. NO. 5, Online publication date: P and Walsh P (2018) to Radical with of Sexual of Urology, VOL. NO. 6, Online publication date: (2018) by of Urology, VOL. NO. 1 Part 1, Online publication date: I and (2018) Treatment for Muscle of the of Urology, VOL. NO. 6, Online publication date: K, P, H, H and F (2018) Cystectomy and Bladder after Preoperative for Bladder CancerJournal of Urology, VOL. NO. 3, Online publication date: and A (2018) Sexual Function and Radical Cystectomy: A of Urology, VOL. NO. 3, Online publication date: J and Walsh P (2018) Radical Prostatectomy with of Sexual Function: in the of Urology, VOL. NO. 6, Online publication date: D and G (2018) of the Prostate: An on of With a Commentary on the of of Urology, VOL. NO. 6, Online publication date: H, M, R, F and Walsh P (2018) of the Autonomic Nerves From the pelvic to the a Anatomical Study of the Male of Urology, VOL. NO. 2, Online publication date: P, Lue T, R, G and J (2018) Penile of Urology, VOL. NO. 2, Online publication date: (2018) by of Urology, VOL. NO. 2, Online publication date: E and Resnick M (2018) Radical ProstatectomyJournal of Urology, VOL. NO. 6, Online publication date: R, R, G and J (2018) Prostatectomy for Localized CancerJournal of Urology, VOL. NO. 1, Online publication date: T, S, R and E (2018) of Penile to of Urology, VOL. NO. 2, Online publication date: H (2018) A View of the of Urology, VOL. NO. 5, Online publication date: T, T and K (2018) Further of the Urethral in Study during and of to of Urology, VOL. NO. 6, Online publication date: E (2018) and the of Urology, VOL. NO. 6, Online publication date: 1982 by The American Urological Association Education and Research, Patrick C. Walsh More articles by this author Pieter J. Donker More articles by this author All