Real-Time Intraoperative Neuromonitoring of Erectile & Urinary Function During Radical Prostatectomy

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Arthur L. Burnett II, MD, MBA, FACS, explores the future of intraoperative neuromonitoring in radical prostatectomy, aiming to improve nerve preservation and functional outcomes. He begins this 19-minute presentation by discussing the complexity of cavernous nerve anatomy, sharing advances in neurostimulation techniques, including sacral-level spinal electrodes and real-time nerve mapping, that offer new possibilities for identifying and protecting functional nerves during surgery.

Dr. Burnett shows how machine learning and artificial intelligence are integrated into this approach, allowing for real-time intraoperative feedback to enhance surgical precision. Novel imaging and electrophysiologic mapping techniques are being developed to localize and selectively preserve erectile-function-specific nerves. Postoperative innovations, such as implantable neurostimulators, are also under investigation to accelerate nerve regeneration and erectile function recovery within months of surgery. The potential impact extends beyond preserving erectile function, with implications for urinary continence and overall patient quality of life.

Dr. Burnett underscores that while nerve-sparing techniques have advanced, integrating real-time neuromonitoring represents the next frontier in improving surgical outcomes. This evolving technology may fundamentally change how radical prostatectomy is performed, and ongoing research will determine its clinical adoption.
Category
Urology
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