New device reduces risk of post prostatectomy incontinence

New device reduces risk of post prostatectomy incontinence

  • On July 24, 2012

A ‘nerve-spotter’ is being tested as a way to reduce nerve damage which can cause incontinence following surgery. The device detects the location of crucial nerves buried in the tissue and invisible to the eye, thus enabling surgeons to avoid accidentally severing them.

Doctors are now trialling it in prostate surgery to reduce post-operative incontinence and impotence. It’s estimated that around 30 per cent of prostate cancer patients suffer some degree of erectile dysfunction after a prostatectomy (prostate gland removal). This is usually a result of damage to two sets of nerves next to the prostate gland, one set of which controls sexual functioning and the other continence. In some cases, these side-effects are temporary, but in around 20 per cent of patients they can last for up to two years or longer. Many men will use male incontinence pads during this period.

At the moment, surgeons have relatively unsophisticated ways of avoiding the nerves, relying on anatomical ‘signposts’ such as the seminal vesicles (tiny sacs at the back of the prostate gland) and their judgment, however the problem is that these markers vary with each man.

The new device, called the ProPep Nerve Monitoring System, helps the surgeon monitor the position of the nerves. Two wire-like electrodes are placed in the tissue around the prostate and urethra (the tube that carries urine from the bladder) and these electrodes are connected to an external monitor.

The electrodes emit a small electrical current and the speed at which this current passes through the tissue shows if there is a nerve there as nerves, unlike tissue, are highly efficient carriers of electricity. When nerves are detected, the electrodes produce a warning signal, displayed on the monitor for the surgeon to see during the operation.

‘Surgeons welcome anything that will help pinpoint the nerves to give better outcomes for sexual function and continence,’ said Professor Raj Persad

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