Objectives. To determine whether preservation of the neurovascular bundles
(NVBs), defined by a positive CaverMap response, correlates with the recove
ry of potency after radical prostatectomy.
Methods. We studied a group of 60 men who were potent preoperatively who un
derwent radical retropubic prostatectomy by one surgeon. The CaverMap was u
sed after removal of the prostate to assess the integrity of the NVBs. Post
operative potency was assessed by a postal questionnaire and telephone inte
rview, administered independently of the treating surgeon. Men were conside
red potent if they reported postoperative erections consistently sufficient
for vaginal penetration with or without the use of sildenafil.
Results. The mean patient age was 59 years, and the median follow-up was 36
5 days. A positive CaverMap response was obtained in 73 (77%) of the 95 NVB
s tested. The overall potency rate was 18%. No patients with a bilateral ne
gative CaverMap response were potent, and 2 (22%) of 9 with a unilateral Ca
verMap response (negative versus unilateral response, P = 0.46) and 6 (27%)
of 22 with bilateral CaverMap responses (negative versus bilateral respons
e, P = 0.32) were potent.
Conclusions. A positive CaverMap response, suggesting that a successful ner
ve-sparing prostatectomy had been performed, was obtained in 77% of the NVB
s tested. Nevertheless, with a median follow-up of 12 months, most patients
with a positive CaverMap response remained impotent. This suggests that ot
her factors are critical to the recovery of sexual function after radical p
rostatectomy. UROLOGY 56: 561-564, 2000. (C) 2000, Elsevier Science Inc.