Conclusions: CD produced a significantly higher potency rate at 1 month following LRP but similar rates thereafter, which are in step with previously reported values (Rozet, 2004). Notably, CD failed to reproduce the results of Menon et al. despite the advantage of avoiding cautery at all stages during NVB preservation in our patients. We believe that the merit of this technique is in allowing a clearer appreciation of the contour of the prostate base at the commencement of antegrade NVB dissection, rather than preserving important nerve fibres. This may explain the lower basal positive margin rate in the CD group of 0% vs 5.8% in control cases (p=0.007).
I often save the veil of aphrodite, but I am not sure that it helps much either in terms of nerve preservation.
I am not sure if the nerve fibers that are seen high on the prostate are going to the penis. I am also concerned about getting too close to the prostate in this area. I think the more important factor that helps restore erections is to leave the prostatic fascia over the neuro-vascular bundles. This leads to less stretch and trauma to the nerves. This intrafascial plane likely leads to the best nerve sparing.