Changing approach to the prostate as the way of nerve-sparing effect improvement in patients with laparoscopic prostatectomy

The use of prostatespecific antigen screening made it possible to detect an earlystage prostate cancer in young men in which nervesparing radical prostatectomy with preservation of erectile function could be performed. Laparoscopic radical prostatectomy (LRPE) is preferred as a nervesparing technique in the treatment of prostate cancer. During the last 2 years 19 patients underwent the modified Brussels technique transperitoneal LRPE, (extrafascial prostatectomy – 17, interfascial – 2). The average period of observation was 10.3 months. 13 of 14 patients were observated more than 6 months. In this group all patients achieved a complete continence, one of the patients remained urine leak with no more than 1 strip a day. Brussels technique provides better control of neurovascular fibers in the seminal vesicles during radical prostatectomy. Posterior approach to the prostate gland should be avoided in the nervesparing LRPE.