Indications and contraindications for nerve-sparing radical prostatectomy

With the success of prostate-specific antigenscreening programs, many prost ate cancers are being diagnosed at an earlier stage when men are more conce rned about maintaining sexual function. Cavernous nerve preservation surger y employed to preserve erectile function can be performed safely in the maj ority of men undergoing radical prostatectomy. Nonetheless, as the primary goal of any extirpative cancer operation is to remove all of the tumor, fac tors that are associated with an increased risk of leaving a positive surgi cal margin must be taken into consideration when evaluating a patient for n erve preservation surgery. This article discusses contraindications to nerv e-sparing radical prostatectomy and describes the use of standardized froze n section analysis to help guide intraoperative decision-making regarding n eurovascular bundle preservation.