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Ask the Doctor: Nerve-Sparing Prostatectomy

Generally, men in their 50s and 60s with cancer of the prostate are prime candidates for radical prostatectomy (removal of the entire gland), but there is no age limit. Nerve-sparing prostatectomy involves removing the entire prostate while leaviving intact the nerves that run underneath the gland that control the ability to get an erection. These nerves resemble thread-like fibers that are easily damaged, requiring precise surgical technique to spare them. Suitability for nerve-sparing prostatectomy largely depends on two factors: whether the urologist can feel a palpable nodule during a rectal exam (a sign of cancer on the gland's surface) and the Gleason score (based on pathological examination of extracted prostate tissue). the higher the schore, the more advanced the cancer.

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