Volume 63, Issue 3, Pages (March 2013)

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Volume 63, Issue 3, Pages 438-444 (March 2013) Effect of a Risk-stratified Grade of Nerve-sparing Technique on Early Return of Continence After Robot-assisted Laparoscopic Radical Prostatectomy Abhishek Srivastava, Sameer Chopra, Anthony Pham, Prasanna Sooriakumaran, Matthieu Durand, Bilal Chughtai, Siobhan Gruschow, Alexandra Peyser, Niyati Harneja, Robert Leung, Richard Lee, Michael Herman, Brian Robinson, Maria Shevchuk, Ashutosh Tewari European Urology Volume 63, Issue 3, Pages 438-444 (March 2013) DOI: 10.1016/j.eururo.2012.07.009 Copyright © 2012 European Association of Urology Terms and Conditions

Fig. 1 Algorithm for risk-stratified approach to nerve sparing. Prostate-specific antigen levels in nanograms per milliliter. Risk grade 1: All criteria should be met; risk grade 2–4: any two criteria or magnetic resonance imaging (MRI) findings. If MRI findings are not available, only clinical criteria are used. EPE=extraprostatic extension; eMRI=endorectal magnetic resonance imaging; PSA=prostate-specific antigen. (From [13,14].) European Urology 2013 63, 438-444DOI: (10.1016/j.eururo.2012.07.009) Copyright © 2012 European Association of Urology Terms and Conditions

Fig. 2 Histology of non-nerve-sparing radical prostatectomy specimen with wide excision of adjacent tissue. Note the distribution of nerve fibers (highlighted in green) in the periprostatic fascial layers. The collapsible veins on the prostate capsule (outlined in blue) are a distinct anatomic landmark; most of the periprostatic nerve fibers lie lateral to these veins. Notice also the area of extraprostatic extension of cancer through the prostate capsule adjacent to these veins. N=nerve; EPE=extraprostatic extension. (From [13,14].) European Urology 2013 63, 438-444DOI: (10.1016/j.eururo.2012.07.009) Copyright © 2012 European Association of Urology Terms and Conditions

Fig. 3 Layers of fascia enveloping prostatic capsule, demonstrating the planes of dissection for differing grades (1–4) of nerve sparing. LPF=lateral pelvic fascia; LF=levator fascia; LA=levator ani. (From [13,14].) European Urology 2013 63, 438-444DOI: (10.1016/j.eururo.2012.07.009) Copyright © 2012 European Association of Urology Terms and Conditions