A radical prostatectomy is a surgical procedure to remove the entirety of the prostate gland, usually due to the presence of cancer within the prostate.
A nerve sparing radical prostatectomy is where the nerves around the prostate gland (prostatic nerve plexus) are preserved whilst the prostate gland is removed. The prostatic nerve plexus is intricately wrapped directly around the prostate gland and is highly susceptible to injury. These nerves are responsible for erectile function and as such damage to these nerves typically leads to erectile dysfunction. It is also possible that damage to these nerves can contribute to urinary incontinence as well.
Nerve sparing radical prostatectomy surgery is a technically challenging surgery and so whilst all efforts may be made to preserve the nerves, damage could easily be done inadvertently. There are a number of factors which influence whether the nerves can be spared. Individual circumstances should be discussed with your surgeon to determine whether a nerve sparing procedure is an appropriate option for you.
In general, the extent of cancer within the prostate will dictate whether the nerves are able to be spared. Cancer which has spread around the prostatic nerve plexus, has resulted in lumps around the prostate developing or has resulted in thickening of the tissue around the prostate, tend to reduce the likelihood of the nerves being able to be spared by the surgeon.
Finally, factors of age and sexual activity may be appropriate to consider by both the patient and the surgeon as to the importance of maintaining erectile function.