Despite optimism regarding SNG, long-term functional outcomes have been disappointing, particularly for BL nerve interposition. UL-SNG functional outcomes do not appear to improve outcomes when compared with men with UL nerve preservation. With the greater risk of PSM and BCR in patients who are considered candidates for SNG, newer treatment modalities are needed to cure their disease while preserving SF.
My friend Dr. Shalhav and his team at Chicago haver reported on their results for nerve grafting in men whose nerves are removed for better cancer control.
This study has been consistent with most studies that have not shown a benefit.
The main problem with the neurovascualr bundle is that it is not a nerve, but a fine complex of micro-nerves. It never made sense to me how one nerve would replace these and re-connect the nerves that are cut.
Possibly in the future we can have tissue that can build new nerves on it. I have not been performing these nerve grafts.