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Nerves sparing

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User

Posted 26 Apr 2025 at 13:53

My partner had his operation yesterday when the surgeon rang later he said they couldn't spare one sign so removed nerve as it showed cancer I know it's linked to nerve function for erection. Apart from this are there worse outcomes or any other consequences and side effects. He had said he hoped to spare both sides. Thanks.

User

Posted 26 Apr 2025 at 18:37

Hi.

Nerve sparing is best. Partial nerve sparing is next best. Non nerve sparing is worst. The nerve sparing only affects erections, nothing else.

Edited by member 26 Apr 2025 at 18:40 | Reason: Typo

User

Posted 26 Apr 2025 at 20:28

Welsh1, you can still have a fantastic sex life without being able to get natural erections. You just have to change your routine and talk to each other. Take what ever is on offer , never give up, think outside the box and have fun finding a solution.

Thanks Chris

User

Posted 26 Apr 2025 at 22:20

Welsh

We understand how you feel. We have been there 13 years ago but still having great sex! There is some evidence that the vast majority of prostatectomies are not as successful as men hope and even most consultants promise. Younger men tend to do better than the others. I suffer from both ED and arousal climacturia but still have a great sex life, different but with unexpected benefits. Have a look at my series of posts at this link:

https://community.prostatecanceruk.org/posts/t28948-Re-establishing-Sex-Life

'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.' Richard Feynman (1918-1988) Nobel Prize laureate

User

Posted 27 Apr 2025 at 08:45

My husband and I were told on more than one occasion by the surgeon that nerve sparing helped with regaining full continence post surgery. This does not mean that continence will not be recovered if there is non nerve sparing but this may impact on the speed and ease with which this goal is achieved. My husband had the Retizus approach undertaken at Royal Marsden. This approach increases the probability of achieving full continence quickly but as I have said the surgeon was clear that nerve sparing was also important for this too.

User

Posted 27 Apr 2025 at 12:16

Originally Posted by: Online Community Member

My husband and I were told on more than one occasion by the surgeon that nerve sparing helped with regaining full continence post surgery.

Hi IDK,

My surgeon did not associate nerve sparing with incontinence. After the op which was non nerve sparing he told me, by removing all nerves, the likelihood of me ever getting a natural etection was remote. Unfortunately, to date, that is the case. He also said that the uretha rejoining was very good and I should have not have much problem with incontinence which was also the case. I therefore assumed, that non nerve sparing only affected erections and not incontinence.

However, after reading your post, I've found research supporting your surgeon's opinion that nerve sparing does also affect incontinence.

I stand corrected. (well, that's still my dream. 🙂)

Edited by member 27 Apr 2025 at 12:19 | Reason: Typo

User

Posted 27 Apr 2025 at 13:42

Hi Welsh1

Here is an abstract from a published paper:

Abstract

Context

In men with prostate cancer, urinary incontinence is one of the most common long-term side effects of radical prostatectomy (RP). The recovery of urinary continence in patients is positively influenced by preserving the integrity of the neurovascular bundles (NVBs). However, it is still unclear if bilateral nerve sparing (BNS) is superior to unilateral nerve sparing (UNS) in terms of post-RP urinary continence. The aim of this study is to systematically compare the differences in post-RP urinary continence outcomes between BNS and UNS.

The paper can be found via the following link:

https://wjso.biomedcentral.com/articles/10.1186/s12957-024-03340-6

'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.' Richard Feynman (1918-1988) Nobel Prize laureate

User

Posted 27 Apr 2025 at 15:29

Thanks we have to go forward and take it as its comes one side was spared. It's the continence side ǰof things that he and I am concerned with and obviously hoping not to need to have radiotherapy.

User

Posted 28 Apr 2025 at 21:04

Good luck Welsh. Unfortunately there are contradictory wishes here, to minimise the risk of recurrence the surgeon needs to take more than the minimum, to minimise side effects he or she needs to prioritise leaving nerve function.

From my reading it isn't the nerves around the prostate that most influence continence, problems with that are more likely around the way the prostate is separated from the bottom of the bladder. And that isn't really an issue of the surgeon's skill, it is about individual variation in the way the top of the prostate does or doesn't overlap the functional sphincter (which unfortunately is not something surgeons can currently visualise during the operation). But those nerves are definitely important in erectile function!

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