The Discovery of the Cavernous Nerves and Development of Nerve Sparing Radical Retropubic Prostatectomy

No AccessJournal of UrologyHistorical article1 May 2007The Discovery of the Cavernous Nerves and Development of Nerve Sparing Radical Retropubic Prostatectomy Patrick Craig Walsh Patrick Craig WalshPatrick Craig Walsh View All Author Informationhttps://doi.org/10.1016/j.juro.2007.01.012AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: This review is of the events that led up to the discovery of the cavernous nerves and the development of nerve sparing radical retropubic prostatectomy. Materials and Methods: The correspondence between Pieter J. Donker and Patrick C. Walsh, along with the publication folders describing the anatomy of the dorsal vein complex, pelvic plexus and cavernous nerves, and pelvic fascia, are reviewed. Results: Serendipity had a major role in the fateful meeting of Pieter J. Donker and Patrick C. Walsh on February 13, 1981 when they dissected out the cavernous nerves in a stillborn male infant. During the next year intraoperative observations identified the capsular arteries and veins of the prostate as the likely microscopic landmark that could be used in the adult male pelvis to identify the microscopic cavernous nerves. Twenty-five years ago, on April 26, 1982, the first purposeful nerve sparing radical prostatectomy was performed. One year following surgery patient sexual function was normal, and 25 years later he has retained his quality of life and an undetectable prostate specific antigen. Conclusions: The events that led up to the first nerve sparing radical prostatectomy illustrate the influence of serendipity on discovery. References 1 : The early diagnosis and radical cure of carcinoma of the prostate: being a study of 40 cases and presentations of a radical operation which was carried out in 4 cases. Bull Johns Hopkins Hosp1905; 16: 315. 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Google Scholar James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland© 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited ByLepor H (2016) Surgical Treatment of Prostate CarcinomaJournal of Urology, VOL. 197, NO. 2S, (S41-S42), Online publication date: 1-Feb-2017.Gilbert S, Dunn R, Miller D, Montgomery J, Skolarus T, Weizer A, Wood D and Hollenbeck B (2018) Functional Outcomes Following Nerve Sparing Prostatectomy Augmented with Seminal Vesicle Sparing Compared to Standard Nerve Sparing Prostatectomy: Results from a Randomized Controlled TrialJournal of Urology, VOL. 198, NO. 3, (600-607), Online publication date: 1-Sep-2017.Bellina M, Mari M, Ambu A and Mangione F (2018) Re: Hydrodissection of Neurovascular Bundles During Open Radical Prostatectomy Improves Postoperative PotencyJournal of Urology, VOL. 187, NO. 3, (1136-1136), Online publication date: 1-Mar-2012.Mullins J, Feng Z, Trock B, Epstein J, Walsh P and Loeb S (2018) The Impact of Anatomical Radical Retropubic Prostatectomy on Cancer Control: The 30-Year AnniversaryJournal of Urology, VOL. 188, NO. 6, (2219-2224), Online publication date: 1-Dec-2012.Gratzke C, Strong T, Gebska M, Champion H, Stief C, Burnett A and Bivalacqua T (2018) Activated RhoA/Rho Kinase Impairs Erectile Function After Cavernous Nerve Injury in RatsJournal of Urology, VOL. 184, NO. 5, (2197-2204), Online publication date: 1-Nov-2010.Hisasue S, Hashimoto K, Kobayashi K, Takeuchi M, Kyoda Y, Sato S, Masumori N and Tsukamoto T (2018) Baseline Erectile Function Alters the Cavernous Nerve Quantity and Distribution Around the ProstateJournal of Urology, VOL. 184, NO. 5, (2062-2067), Online publication date: 1-Nov-2010.Litwin M (2018) Commentary on Urinary and Sexual Outcomes after Radical ProstatectomyJournal of Urology, VOL. 179, NO. 5S, (S45-S46), Online publication date: 1-May-2008. Volume 177Issue 5May 2007Page: 1632-1635 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordsimpotenceprostatectomyprostatic neoplasmsMetricsAuthor Information Patrick Craig Walsh More articles by this author Expand All Advertisement PDF DownloadLoading ...