SEOUL NATIONAL UNIVERSITY HOSPITAL

Researchers at Seoul National University Hospital (SNUH) have developed a new surgery method that can reduce the side effects of prostate cancer surgery, including erectile dysfunction.

Professors Jeong Chang-wook (left) and Kim Kee-won

Erectile dysfunction is most common after radical prostatectomy, the most common treatment for prostate cancer, and is a complication that has seen no significant improvement over the past few decades, despite the use of robots in prostate cancer surgery.

Such adverse effects occur due to the surgery having considerable damage to the cavernous nerve, which is the nerve involved in the erection. Although various surgical methods of preserving the cavernous nerves have been developed, the results have not been satisfactory as they are not visible or can be measured.

The team, led by Professors Jeong Chang-wook and Kim Kee-won, became the world's first to develop a method for direct electrical stimulation of the cavernous nerves and conduct a corpus cavernosum electromyography in the penis through multidisciplinary research.

The team also conducted the world's first human phase 1 and 2 prospective clinical trials that demonstrated the method have no adverse effects on the patient and that the results of corpus cavernosum electromyography before prostatectomy showed a significant correlation with the patient's erection.

As a result, the team confirmed that corpus cavernosum electromyography after prostatectomy showed a significant correlation with postoperative erection recovery and proved that the method is a clinically useful intraoperative nerve monitoring method.

"Not all patients will be able to conserve nerves by applying this procedure," Professor Jeong said. "Surgical methods should be determined in consideration of the progression and malignancy of prostate cancer."

While this method will reduce erectile dysfunction, it will not prevent all cases, Jeong added.

Jeong stressed that the study established the basic technology to identify erectile nerves accurately, and various large-scale clinical studies need to be conducted in the future.

Professor Kim Kee-won also said, "Electrical monitoring of nerves during surgery has increased its importance in clinical practice worldwide recently. The study has great academic significance in that it is the first study to directly stimulate and record the autonomic nervous system, which has not been evaluated by conventional surgical neurosurgical techniques."

The team noted that it is preparing a large-scale multicenter clinical trial with leading hospitals around the world, such as the University of California San Francisco, in the hopes of dramatically improving erection retention after prostate cancer surgery.

The results of the research were published in the European Urology.

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