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Anatomic Foundations and Physiology of Erectile Function and Urinary Continence

  • Deepansh DalelaEmail author
  • Mani Menon
Chapter

Abstract

The widespread use of PSA screening since the 1990s and the consequent downward stage migration of incident prostate cancer (PCa) in the United States has led to an increasing number of younger patients undergoing radical prostatectomy for clinically localized PCa. While this has led to higher disease specific and overall survival, it has also highlighted the critical role of functional outcomes (i.e., urinary continence and erectile function) in affecting the health-related quality of life for the PCa survivor. It is in this context that robot-assisted laparoscopic surgery offers tremendous opportunities, with its magnified, 3-dimensional view, more degree of freedom of movements, and the ability to carry out precise tissue dissections. The ability to translate these technological advancements into superior functional outcomes is, however, firmly predicated on a clear understanding of the underlying principles of anatomical and physiological interactions responsible for maintaining urinary continence and erectile function. This chapter is intended to discuss the evolution of current understanding of these aspects.

Keywords

Radical prostatectomy Robotics Urinary continence Erectile function Neurovascular bundle Veil of Aphrodite Periprostatic fascia External urinary sphincter 

Notes

Acknowledgment

Financial disclosures and conflicts of interest: None.

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.VUI Center for Outcomes Research, Analytics and Evaluation, Vattikuti Urology InstituteHenry Ford Health SystemDetroitUSA

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