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Does robot-assisted prostate surgery reduce the risk of impotence? by Vincent Rogers
When the internationally renowned composer Andrew Lloyd-Webber recently spoke about being impotent following prostate cancer surgery, he opened up an important but not widely discussed issue. There are an estimated 36,000 men who develop prostate cancer in the UK each year and around one third of them will opt for surgery. Known medically as a prostatectomy, or complete removal of the prostate, the procedure has long been associated with long term impotence.
This is because during a traditional, radical prostatectomy, the surgeon removes the whole prostate gland, along with both seminal vesicles, both ampullae (the enlarged lower sections of the vas deferens) and additional surrounding tissues. A tangle of nerves, known as the neurovascular bundles, run on both sides of the prostate and control erections. The radical prostatectomy involved using wide margins around the prostate glands and causing irreparable damage to the neurovascular bundles. During the past decade, some specialist surgeons have developed a new approach called the nerve-sparing prostatectomy which is designed to remove the prostate gland while doing as little damage to the neurovascular bundles as possible. But inevitably, this task is very technically demanding and intricate.
Experts like Consultant Urologist Marc Laniado, part of the first team to bring robot assisted prostate surgery to the UK, argue the new technology is ideally suited to achieving optimal nerve-sparing.
