Nerve Repair for Erectile Dysfunction After Radical Prostatectomy: A Systematic Review of Outcomes.
| Title: | Nerve Repair for Erectile Dysfunction After Radical Prostatectomy: A Systematic Review of Outcomes. |
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| Authors: | Chrabieh E; From the Department of Medicine, American University of Beirut, Beirut, Lebanon.; Beaineh P; Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.; Sebai T; Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.; Chekfa AJ; Faculty of Medicine, Damascus University, Damascus, Syria.; Ghieh F; Department of Clinical Research, American University of Beirut, Beirut, Lebanon.; Makkawi K; Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.; Atiyeh B; Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.; Bachir B; Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.; Ibrahim A; Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon. |
| Source: | Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2025 Oct 02; Vol. 13 (10), pp. e7165. Date of Electronic Publication: 2025 Oct 02 (Print Publication: 2025). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Wolters Kluwer Health/Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 101622231 Publication Model: eCollection Cited Medium: Print ISSN: 2169-7574 (Print) Linking ISSN: 21697574 NLM ISO Abbreviation: Plast Reconstr Surg Glob Open Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: [Philadelphia, PA] : Wolters Kluwer Health/Lippincott Williams & Wilkins, [2013]- |
| Abstract: | Background: Erectile dysfunction (ED) is a prevalent complication after radical prostatectomy (RP), affecting up to 89% of patients within 2-5 years due to cavernous nerve injury. Nerve grafting has been proposed as a strategy to restore erectile function, but outcomes remain inconsistent, and randomized controlled trials have yielded mixed results. This review evaluated the effectiveness of nerve grafting techniques for ED management after RP.; Methods: A systematic search of PubMed, MEDLINE, and Embase databases was conducted using terms related to ED, nerve grafting, and cavernous nerve repair. From 239 initial studies, 17 met the inclusion criteria, focusing on human subjects and reporting outcomes of unilateral or bilateral nerve grafting with autologous donor nerves, such as the sural and genitofemoral nerves.; Results: Bilateral sural nerve grafting demonstrated the highest recovery rates, with up to 71% of patients regaining erectile function sufficient for intercourse. Adjunctive therapies like sildenafil were frequently used to enhance outcomes. However, randomized controlled trials showed no statistically significant improvements compared with controls, raising questions about the efficacy of nerve grafting. Variability in outcomes seemed to be influenced by donor nerve choice, surgical expertise, and patient characteristics, such as age and baseline function.; Conclusions: Although bilateral sural nerve grafting offers promising results, its overall efficacy is uncertain due to inconsistent findings and limitations of existing studies. Larger, standardized trials are essential to clarify its role in ED management after RP and to optimize patient outcomes.; (Copyright © 2025 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.) |
| Competing Interests: | The authors have no financial interest to declare in relation to the content of this article. |
| References: | J Sex Med. 2007 Jan;4(1):241-250. (PMID: 17233791); J Urol. 2009 Mar;181(3):1258-63. (PMID: 19152922); Eur Urol. 2019 Aug;76(2):189-196. (PMID: 30955973); J Sex Med. 2010 Oct;7(10):3365-72. (PMID: 20233276); J Sex Med. 2007 Mar;4(2):448-64. (PMID: 17367440); J Urol. 2000 Dec;164(6):1929-34. (PMID: 11061884); Eur Urol. 2009 May;55(5):1135-43. (PMID: 18783876); Urology. 2006 Apr;67(4):789-92. (PMID: 16584763); BJU Int. 2017 Jun;119(6):948-954. (PMID: 28093890); BJU Int. 2013 Jan;111(1):159-70. (PMID: 22672418); Int J Urol. 2007 Feb;14(2):133-9. (PMID: 17302570); J Endourol. 2008 May;22(5):1005-12. (PMID: 18419333); J Urol. 2023 Jun;209(6):1082-1090. (PMID: 37096583); BJU Int. 2017 Jun;119(6):816-818. (PMID: 28544709); Prostate. 2023 Sep;83(13):1290-1297. (PMID: 37350456); J Urol. 2007 Jul;178(1):212-6; discussion 216. (PMID: 17499797); Front Physiol. 2022 Oct 06;13:1029650. (PMID: 36277218); BJU Int. 2007 Nov;100(5):1107-9. (PMID: 17578520); Prostate Cancer Prostatic Dis. 2003;6(1):56-60. (PMID: 12664067); J Peripher Nerv Syst. 2007 Jun;12(2):65-82. (PMID: 17565531); J Urol. 1999 Jan;161(1):188-92. (PMID: 10037395); JAMA. 2000 Jan 19;283(3):354-60. (PMID: 10647798); Urology. 2001 Dec;58(6):983-7. (PMID: 11744473); BJU Int. 2005 Jun;95(9):1267-71. (PMID: 15892814); Jpn J Clin Oncol. 2009 Oct;39(10):671-6. (PMID: 19654133); Int J Mol Sci. 2014 Sep 26;15(10):17204-20. (PMID: 25264738); Urology. 2007 Jun;69(6):1161-4. (PMID: 17572207); J Control Release. 2010 Apr 19;143(2):168-74. (PMID: 20035811); J Urol. 2007 Feb;177(2):664-8. (PMID: 17222654); J Urol. 2001 Jun;165(6 Pt 1):1950-6. (PMID: 11371887) |
| Entry Date(s): | Date Created: 20251006 Date Completed: 20251006 Latest Revision: 20251008 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12490649 |
| DOI: | 10.1097/GOX.0000000000007165 |
| PMID: | 41050970 |
| Database: | MEDLINE |
Journal Article