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Adjunctive Measures and New Therapies to Optimize Early Return of Erectile Function

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Urinary Continence and Sexual Function After Robotic Radical Prostatectomy

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Abstract

Even after the advent of nerve-sparing procedure a significant percent of patients still develop erectile dysfunction after radical prostatectomy [1]. Modifications in the surgical technique of robotic radical prostatectomy have aimed not only to spare the cavernous nerve but also to minimize any potential harm done from manipulation, traction, or thermal injury of the nerves in addition to sparing the microcirculation surrounding the prostate. The adjunctive measures to optimize early return of erectile function can be subdivided into intraoperative measures designed to optimize nerve preservation and minimize injury to the neurovascular structures surrounding the prostate, and postoperative penile rehabilitation to facilitate early return of erectile function.

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References

  1. Dubbelman D, Dohle R, Schroder H. Sexual function before and after radical retropubic prostatectomy: a systemic review of prognostic indicators for successful outcome. Eur Urol. 2006;50:711–8.

    Article  PubMed  Google Scholar 

  2. Mulhall J. Defining and reporting erectile function outcomes after radical prostatectomy: challenges and miscoceptions. J Urol. 2009;181:462–71.

    Article  PubMed  Google Scholar 

  3. Dahm P, Stoffs T, Canfield SE. Recovery of erectile function after robotic prostatectomy:evidence based outcomes. Urol Clin N Am. 2011;38(24):6.

    Google Scholar 

  4. Fairbain NG, Redmond RW. The clinical application of human amnion in plastic surgery. J Plast Reconstr Aesthet Surg. 2014;67(5):665–75.

    Google Scholar 

  5. Fesli A, Yilmaz N, Comelekoglu U, Tasdelen B. Enhancement of nerve healing with the combined use of amniotic membrane and granulocyte colony stimulation factor. J Plast Reconstr Aesthet Surg. 2014;67(5):837–43.

    Article  PubMed  Google Scholar 

  6. Kim N, Verdi Y, Padma-Nathan H, Daley J, Goldstein I, Saenz de Tejada I. Oxygen tension regulates the nitric oxide pathway. Physiologic role in penile erection. J Clin Invest. 1993;91:437–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Klein L, Miller M, Buttyan R, et al. Apoptosis in the rat penis after penile denervation. J Urol. 1997;158:626–30.

    Article  CAS  PubMed  Google Scholar 

  8. Lue T, Tanagho E. Physiology of erection and pharmacological management of impotence. J Urol. 1987;137:829–36.

    CAS  Google Scholar 

  9. Mulhall J, Slovick R, Hotaling J, et al. Erectile dysfunction after radical prostatectomy: hemodynamic profiles and their correlation with recovery of erectile function. J Urol. 2002;167:1371–5.

    Article  PubMed  Google Scholar 

  10. Montorsi F, Guazzoni G, Strambi LF, et al. Recovery of spontaneous erectile function after nerve-sparing radical retropubic prostatectomy with and without early intracavernous injections of alprostadil: results of a prospective, randomized trial. J Urol. 1997;158:1408–10.

    Article  CAS  PubMed  Google Scholar 

  11. Nandipati K, Raina R, Agarwal A, et al. Early combination therapy: intracavernosal injections and sildenafil following radical prostatectomy increases sexual activity and the return of natural erections. Int J Impot Res. 2006;18:446–51.

    Article  CAS  PubMed  Google Scholar 

  12. Bannowsky A, Schulze H, van der Horst C, et al. Recovery of erectile function after nerve-sparing radical prostatectomy: improvement with nightly low-dose sildenafil. BJU Int. 2008;101:1279–83.

    Article  CAS  PubMed  Google Scholar 

  13. Mulhall J, Land S, Parker M, et al. The use of an erectogenic pharmacotherapy regimen following radical prostatectomy improves recovery of spontaneous erectile function. J Sex Med. 2005;2:532–40. discussion 540–2.

    Article  CAS  PubMed  Google Scholar 

  14. Padma-Nathan H, McCullough AR, Levine LA, Lipshultz LI, Siegel R, et al. Randomized, double-blind, placebo-controlled study of postoperative nightly sildenafil citrate for the prevention of erectile dysfunction after bilateral nerve-sparing radical prostatectomy. Int J Impot Res. 2008;20:479–86.

    Article  CAS  PubMed  Google Scholar 

  15. Mulhall JP, Burnett AL, Wang R, McVary KT, Moul JW, et al. A phase 3, placebo controlled study of the safety and efficacy of avanafil for the treatment of erectile dysfunction after nerve sparing radical prostatectomy. J Urol. 2013;189:2229–36.

    Article  CAS  Google Scholar 

  16. Teloken P, Mesquita G, Montorsi F, Mulhall J. Post-radical prostatectomy pharmacological penile rehabilitation: practice patterns among the international society for sexual medicine practitioners. J Sex Med. 2009;6(7):2032–8.

    Article  PubMed  Google Scholar 

  17. Mulhall JP, Bella AJ, Briganti A, McCullough A, Brock G. Erectile function rehabilitation in the radical prostatectomy patient. J Sex Med. 2010;7(4 Pt 2):1687–98.

    Article  PubMed  Google Scholar 

  18. Schwartz EJ, Wong P, Graydon RJ. Sildenafil preserves intracorporeal smooth muscle after radical retropubic prostatectomy. J Urol. 2004;171(2 Pt 1):771–4.

    Article  PubMed  Google Scholar 

  19. Köhler TS, Pedro R, Hendlin K, Utz W, Ugarte R, Reddy P, et al. A pilot study on the early use of the vacuum erection device after radical retropubic prostatectomy. BJU Int. 2007;100(4):858–62.

    Article  PubMed  Google Scholar 

  20. Raina R, Agarwal A, Ausmundson S, Lakin M, Nandipati KC, Montague DK, et al. Early use of vacuum constriction device following radical prostatectomy facilitates early sexual activity and potentially earlier return of erectile function. Int J Impot Res. 2006;18(1):77–81.

    Article  CAS  PubMed  Google Scholar 

  21. Chung E, Brock G. Sexual rehabilitation and cancer survivorship: a state of art review of current literature and management strategies in male sexual dysfunction among prostate cancer survivors. J Sex Med. 2013;10 Suppl 1:102–11.

    Article  PubMed  Google Scholar 

  22. Salonia A, Burnett AL, Graefen M, Hatzimouratidis K, Montorsi F, Mulhall JP, et al. Prevention and management of postprostatectomy sexual dysfunctions. Part 1: choosing the right patient at the right time for the right surgery. Eur Urol. 2012;62(2):261–72.

    Article  PubMed  Google Scholar 

  23. Chung E, Brock GB. Emerging and novel therapeutic approaches in the treatment of male erectile dysfunction. Curr Urol Rep. 2011;12(6):432–43.

    Article  PubMed  Google Scholar 

  24. García-Cardoso J, Vela R, Mahillo E, Mateos-Cáceres PJ, Modrego J, Macaya C, et al. Increased cyclic guanosine monophosphate production and endothelial nitric oxide synthase level in mononuclear cells from sildenafil citrate-treated patients with erectile dysfunction. Int J Impot Res. 2010;22(1):68–76.

    Article  PubMed  Google Scholar 

  25. Montorsi F, Brock G, Lee J, Shapiro J, Van Poppel H, et al. Effect of nightly versus on-demand vardenafil on recovery of erectile function in men following bilateral nerve-sparing radical prostatectomy. Eur Urol. 2008;54:924–31.

    Article  CAS  PubMed  Google Scholar 

  26. Montorsi F, Brock G, Stolzenburg JU, Mulhall J, Moncada I, et al. Effects of tadalafil treatment on erectile function recovery following bilateral nerve-sparing radical prostatectomy: a randomised placebo-controlled study (REACTT). Eur Urol. 2014;65:587–96.

    Article  CAS  PubMed  Google Scholar 

  27. Natali A, Masieri L, Lanciotti M, Giancane S, Vignolini G, Carini M, et al. A comparison of different oral therapies versus no treatment for erectile dysfunction in 196 radical nerve-sparing radical prostatectomy patients. Int J Impot Res. 2015;27(1):1–5.

    Article  CAS  PubMed  Google Scholar 

  28. Segal R, Burnett AL. Avanafil for the treatment of erectile dysfunction. Drugs Today. 2012;48(1):7–15.

    Article  CAS  PubMed  Google Scholar 

  29. Paick JS, Kim JJ, Kim SC, et al. Efficacy and safety of mirodenafil in men taking antihypertensive medications. J Sex Med. 2010;7(9):3143–52.

    Article  CAS  PubMed  Google Scholar 

  30. Toque HA, Teixeira CE, Lorenzetti R, Okuyama CE, Antunes E, De Nucci G. Pharmacological characterization of a novel phosphodiesterase type 5 (PDE5) inhibitor lodenafil carbonate on human and rabbit corpus cavernosum. Eur J Pharmacol. 2008;591(1–3):189–95.

    Article  CAS  PubMed  Google Scholar 

  31. Alba F, Wang R. Current status of penile rehabilitation after radical prostatectomy. J Urol. 2010;16:93–101.

    Google Scholar 

  32. McCullough AR, Hellstrom WG, Wang R, Lepor H, Wagner KR, Engel JD. Recovery of erectile function after nerve sparing radical prostatectomy and penile rehabilitation with nightly intraurethral alprostadil versus sildenafil citrate. J Urol. 2010;183:2451–6.

    Article  CAS  PubMed  Google Scholar 

  33. Albersen M, Shindel AW, Lue TF. Sexual dysfunction in the older man. Rev Clin Gerontol. 2009;19(4):237–48.

    Article  Google Scholar 

  34. Raina R, Pahlajani G, Agarwal A, Zippe CD. The early use of transurethral alprostadil after radical prostatectomy potentially facilitates an earlier return of erectile function and successful sexual activity. BJU Int. 2007;100(6):1317–21.

    Article  PubMed  Google Scholar 

  35. Burnett AL. Erectile dysfunction following radical prostatectomy. JAMA. 2005;293:2648–53.

    Article  CAS  PubMed  Google Scholar 

  36. Claro JA, de Aboim JE, Maríngolo M, Andrade E, Aguiar W, Nogueira M, et al. Intracavernous injection in the treatment of erectile dysfunction after radical prostatectomy: an observational study. Sao Paulo Med J. 2001;119:135–7.

    Article  Google Scholar 

  37. Gontero P, Fontana F, Bagnasacco A, Panella M, Kocjancic E, Pretti G, et al. Is there an optimal time for intracavernous prostaglandin E1 rehabilitation following nonnerve sparing radical prostatectomy? Results from a hemodynamic prospective study. J Urol. 2003;169(6):2166–9.

    Article  PubMed  Google Scholar 

  38. Mulhall JP, Parker M, Waters BW, Flanigan R. The timing of penile rehabilitation after bilateral nerve-sparing radical prostatectomy affects the recovery of erectile function. BJU Int. 2010;105:37–41.

    Article  PubMed  Google Scholar 

  39. Yiou R, Tow BZ, Parisot J, et al. Is it worth continuing sexual rehabilitation after radical prostatectomy with intracavernous injection of alprostadil for more than 1 year? J Sex Med. 2015;3:42–8.

    Article  CAS  Google Scholar 

  40. Lewis R, Witherington R. External vacuum therapy for erectile dysfunction: use and results. World J Urol. 1997;15:78–82.

    Article  CAS  PubMed  Google Scholar 

  41. Brison D, Seftel A, Sadeghi-Nejad H. The resurgence of the vacuum erection device (VED) for treatment of erectile dysfunction. J Sex Med. 2013;10:1124–35.

    Article  Google Scholar 

  42. Lin H, Yang W, Zhang J, Dai Y, Wang R. Penile rehabilitation with a vacuum erectile device in an animal model is related to an antihypoxic mechanism: blood gas evidence. Asian J Androl. 2013;15:387–90.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Yuan J, Hoang A, Romero C, Lin H, Dai Y, Wang R. Vacuum therapy in erectile dysfunction—science and clinical evidence. Int J Impot Res. 2010;22:211–9.

    Article  CAS  PubMed  Google Scholar 

  44. Yuan J, Lin H, Li P, Zhang R, Luo A, Berardinelli F, et al. Molecular mechanisms of vacuum therapy in penile rehabilitation: a novel animal study. Eur Urol. 2010;58:773–80.

    Article  CAS  PubMed  Google Scholar 

  45. Yuan J, Westney O, Wang R. Design and application of a new rat-specific vacuum erectile device for penile rehabilitation research. J Sex Med. 2009;6:3247–53.

    Article  PubMed  Google Scholar 

  46. Monga M, Utz W, Reddy P, Kohler T, Hendlin K, et al. Early use of the vacuum constriction device following radical retropubic prostatectomy: a randomized clinical trial south central section of the AUA 85th annual meeting; 2006. p. 98.

    Google Scholar 

  47. Bosshardt RJ, Farwerk R, Sikora R, Sohn M, Jakse G. Objective measurement of the effectiveness, therapeutic success and dynamic mechanisms of the vacuum device. Br J Urol. 1995;75:786–91.

    Article  CAS  PubMed  Google Scholar 

  48. Gontero P, Fontana F, Zitella A, Montorsi F, Frea B. A prospective evaluation of efficacy and compliance with a multistep treatment approach for erectile dysfunction in patients after non-nerve sparing radical prostatectomy. BJU Int. 2005;95:359–65.

    Article  PubMed  Google Scholar 

  49. Raina R, Agarwal A, Allamaneni SS, Lakin MM, Zippe CD. Sildenafil citrate and vacuum constriction device combination enhances sexual satisfaction in erectile dysfunction after radical prostatectomy. Urology. 2005;65:360–4.

    Article  PubMed  Google Scholar 

  50. Raina R, Pahlajani G, Agarwal A, Jones S, Zippe C. Long-term potency after early use of a vacuum erection device following radical prostatectomy. BJU Int. 2010;106:1719–22.

    Article  PubMed  Google Scholar 

  51. Engel JD. Effect on sexual function of a vacuum erection device post-prostatectomy. Can J Urol. 2011;18:5721–5.

    PubMed  Google Scholar 

  52. Basal S, Wambi C, Acikel C, Gupta M, Badani K. Optimal strategy for penile rehabilitation after robot-assisted radical prostatectomy based on preoperative erectile function. BJU Int. 2013;111:658–65.

    Article  CAS  PubMed  Google Scholar 

  53. Montorsi F, Adaikan G, Becher E, et al. Summary of the recommendations on sexual dysfunctions in men. J Sex Med. 2010;7(11):3572–88.

    Article  Google Scholar 

  54. Stein M, Lin H. New advances in erectile technology. Ther Adv Urol. 2014;6(1):15–24.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Lim P. Recent advances and research updates. 2003. ISSN-0972-4689.

    Google Scholar 

  56. Le B, Colombo A, Mustoe T, McVary K. Evaluation of a Ni-Ti shape memory alloy for use in a novel penile prosthesis. J Urol. 2013;189(Suppl):502.

    Article  Google Scholar 

  57. Swords K, Martinez D, Lockhart J, Carrion R. A preliminary report on the usage of an intracorporeal antibiotic cast with synthetic high purity CaSO4 for the treatment of infected penile implant. J Sex Med. 2013;10:1162–9.

    Article  CAS  PubMed  Google Scholar 

  58. Yap RL, Mcvary KT. Topical agents and erectile dysfunction: is there a place? Curr Urol Rep. 2002;3:471–6.

    Article  PubMed  Google Scholar 

  59. Montorsi F, Salonia A, Zanoni M, Pompa P, Cestari A, Guazzoni G, et al. Current status of local penile therapy. Int J Impot Res. 2002;14(1 suppl):S70–81.

    Article  PubMed  Google Scholar 

  60. Friedman AJ, Han G, Navati MS, Chacko M, Gunther L, Alfieri A, et al. Sustained release nitric oxide releasing nanoparticles: characterization of a novel delivery platform based on nitrite containing hydrogel/glass composites. Nitric Oxide. 2008;19:12–20.

    Article  CAS  PubMed  Google Scholar 

  61. Gupta R, Kumar A. Bioactive materials for biomedical applications using sol-gel technology. Biomed Mater. 2008;3:034005.

    Article  PubMed  Google Scholar 

  62. Khan I, Dantsker D, Samuni U, Friedman AJ, Bonaventura C, Manjula B, et al. Beta 93 modified hemoglobin: kinetic and conformational consequences. Biochemistry. 2001;40:7581–92.

    Article  CAS  PubMed  Google Scholar 

  63. Khan I, Shannon CF, Dantsker D, Friedman AJ, Perez-Gonzalez-de-Apodaca J, Friedman JM. Sol-gel trapping of functional intermediates of hemoglobin: geminate and bimolecular recombination studies. Biochemistry. 2000;39:16099–109.

    Article  CAS  PubMed  Google Scholar 

  64. Viitala R, Jokinen M, Rosenholm JB. Mechanistic studies on release of large and small molecules from biodegradable SiO2. Int J Pharm. 2007;336:382–90.

    Article  CAS  PubMed  Google Scholar 

  65. Han G, Tar M, Kuppam D, Friedman A, Melman A, Friedman J, et al. Nanoparticles as a novel delivery vehicle for therapeutics targeting erectile dysfunction. J Sex Med. 2010;7:224–33.

    Article  CAS  PubMed  Google Scholar 

  66. Davies KP, Tar M, Rougeot C, Melman A. Sialorphin (the mature peptide product of Vcsa1) relaxes corporal smooth muscle tissue and increases erectile function in the ageing rat. BJU Int. 2007;99:431–5.

    Article  CAS  PubMed  Google Scholar 

  67. Seftel AD. Phosphodiesterase type 5 inhibitor differentiation based on selectivity, pharmacokinetic, and efficacy profiles. Clin Cardiol. 2004;27(4 suppl 1):114–9.

    Google Scholar 

  68. Jetter A, Kinzig-Schippers M, Walchner-Bonjean M, Hering U, Bulitta J, Schreiner P, et al. Effects of grapefruit juice on the pharmacokinetics of sildenafil. Clin Pharmacol Ther. 2002;71:21–9.

    Article  CAS  PubMed  Google Scholar 

  69. Young S, Dyson M. The effect of therapeutic ultrasound on angiogenesis. Ultrasound Med Biol. 1990;16:261–9.

    Article  CAS  PubMed  Google Scholar 

  70. Qiu X, Lin G, Xin Z, Ferretti L, Zhang H, Lue T, et al. Effects of low-energy shockwave therapy on the erectile function and tissue of a diabetic rat model. J Sex Med. 2013;10:738–46.

    Article  CAS  PubMed  Google Scholar 

  71. Wang C, Huang H, Pai C. Shock wave-enhanced neovascularization at the tendon-bone junction: an experiment in dogs. J Foot Ankle Surg. 2002;41:16–22.

    Article  CAS  PubMed  Google Scholar 

  72. Wang C, Wang F, Yang K, Weng L, Hsu C, Huang C, et al. Shock wave therapy induces neovascularization at the tendon-bone junction. A study in rabbits. J Orthop Res. 2003;21:984–9.

    Article  PubMed  Google Scholar 

  73. Gutersohn A, Caspari G, Vopahl M, Erbel R. Upregulation of VEGF mRNA in HUVEC via shock waves. In: Proceedings of the international conference from genes to therapy in ischemic and heart muscle disease, Marburg, Germany, 9–10 Oct 1999.

    Google Scholar 

  74. Nishida T, Shimokawa H, Oi K, Tatewaki H, Uwatoku T, Abe T, et al. Extracorporeal cardiac shock wave therapy markedly ameliorates ischemia-induced myocardial dysfunction in pigs in vivo. Circulation. 2004;110:3055–61.

    Article  PubMed  Google Scholar 

  75. Aicher A, Heeschen C, Sasaki K, Urbich C, Zeiher A, Dimmeler S. Low-energy shock wave for enhancing recruitment of endothelial progenitor cells: a new modality to increase efficacy of cell therapy in chronic hind limb ischemia. Circulation. 2006;114:2823–30.

    Article  PubMed  Google Scholar 

  76. Vardi Y, Appel B, Jacob G, Massarwi O, Gruenwald I. Can low-intensity extracorporeal shockwave therapy improve erectile function? A 6-month follow-up pilot study in patients with organic erectile dysfunction. Eur Urol. 2010;58:243–8.

    Article  PubMed  Google Scholar 

  77. Vardi Y, Appel B, Kilchevsky A, Gruenwald I. Does low intensity extracorporeal shock wave therapy have a physiological effect on erectile function? Short-term results of a randomized, double-blind, sham controlled study. J Urol. 2012;187:1769–75.

    Article  PubMed  Google Scholar 

  78. Walz J, Burnett AL, Costello AJ, Eastham JA, Graefen M, Guillonneau B, et al. A critical analysis of the current knowledge of surgical anatomy related to optimization of cancer control and preservation of continence and erection in candidates for radical prostatectomy. Eur Urol. 2010;57:179–92.

    Article  PubMed  Google Scholar 

  79. Rogers CG, Trock BP, Walsh PC. Preservation of accessory pudendal arteries during radical retropubic prostatectomy: surgical technique and results. Urology. 2004;64:148–51.

    Article  PubMed  Google Scholar 

  80. Mulhall JP, Secin FP, Guillonneau B. Artery sparing radical prostatectomy – myth or reality? J Urol. 2008;179:827–31.

    Article  PubMed  Google Scholar 

  81. Moreland RB. Is there a role of hypoxemia in penile fibrosis: a viewpoint presented to the Society for the Study of Impotence. Int J Impot Res. 1998;10:113–20.

    Article  CAS  PubMed  Google Scholar 

  82. Nehra A, Hall SJ, Basile G, Bertero EB, Moreland R, Toselli P, et al. Systemic sclerosis and impotence: a clinicopathological correlation. J Urol. 1995;153:1140–6.

    Article  CAS  PubMed  Google Scholar 

  83. Pelka R, Jaenicke C, Gruenwald J. Impulse magnetic-field therapy for erectile dysfunction: a double-blind, placebo-controlled study. Adv Ther. 2002;19:53–60.

    Article  PubMed  Google Scholar 

  84. Shafik A, El-Sibai O, Shafik A. Magnetic stimulation of the cavernous nerve for the treatment of erectile dysfunction in humans. Int J Impot Res. 2000;12:137–41. discussion 141–132.

    Article  CAS  PubMed  Google Scholar 

  85. Tajkarimi K, Burnett A. Viberect® device use by men with erectile dysfunction: safety, ease of use, tolerability, and satisfaction survey. J Sex Med. 2011;8:441.

    Article  Google Scholar 

  86. Fode M, Borre M, Ohl DA, Lichtbach J, Sønksen J. Penile vibratory stimulation in the recovery of urinary continence and erectile function after nerve-sparing radical prostatectomy: a randomized, controlled trial. BJU Int. 2014;114:111–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  87. Yoo J, Lee I, Atala A. Cartilage rods as a potential material for penile reconstruction. J Urol. 1998;160:1164–8. discussion 1178.

    Article  CAS  PubMed  Google Scholar 

  88. Yoo J, Park H, Lee I, Atala A. Autologous engineered cartilage rods for penile reconstruction. J Urol. 1999;162:1119–21.

    Article  CAS  PubMed  Google Scholar 

  89. Kershen R, Yoo J, Moreland R, Krane R, Atala A. Reconstitution of human corpus cavernosum smooth muscle in vitro and in vivo. Tissue Eng. 2002;8:515–24.

    Article  PubMed  Google Scholar 

  90. Chen K, Eberli D, Yoo J, Atala A. Bioengineered corporal tissue for structural and functional restoration of the penis. Proc Natl Acad Sci U S A. 2010;107:3346–50.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. International Robotic Prostatectomy Institute, Urology Center of Excellence at Jackson South Hospital, Deering Medical Plaza, 9380 SW 150th Street, Suite 200, Miami, FL, 33176, USA

    Nizar Boudiab M.D., Usama Khater M.D. & Sanjay Razdan M.D., M.Ch.

  2. University of Miami Miller School of Medicine, Miami, FL, USA

    Shirin Razdan B.S.

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  1. Nizar Boudiab M.D.
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  1. International Robotic Prostatectomy Institute, Urology Center of Excellence at Jackson South Hospital, Miami, Florida, USA

    Sanjay Razdan

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Nerve preservation judicious use of thermal energy with dHam wrap (MP4 199313 kb)

Optimizing erectile function with accessory pudendal artery preservation and judicious use of thermal energy (MP4 75084 kb)

First in the world use of amniotic membrane in robotic prostatectomy for early return of erections (MP4 116775 kb)

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Boudiab, N., Khater, U., Razdan, S., Razdan, S. (2016). Adjunctive Measures and New Therapies to Optimize Early Return of Erectile Function. In: Razdan, S. (eds) Urinary Continence and Sexual Function After Robotic Radical Prostatectomy. Springer, Cham. https://doi.org/10.1007/978-3-319-39448-0_9

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