Non-nerve sparing defined

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Regular Member

Date Joined Feb 2011
Total Posts : 45
   Posted 5/11/2011 2:34 PM (GMT -6)   
When there is non-nerve sparing on one side, does it mean that there is more incontinece issues, or does non-nerve sparing only relate to increased erection issues?   Very confusing.  They took out nerves on one side, but spared nerves on the other side.  
And what does it mean focal perineural invasion?  Thanks.

Veteran Member

Date Joined Sep 2010
Total Posts : 2680
   Posted 5/11/2011 2:52 PM (GMT -6)   
I can't give  you a real answer, but my own personal experience was that they were only able to save the nerves on my right side.  Nevertheless, I never had a real problem with incontinence (wore the same pad all day from the start), and was completely dry at about the 8-week mark.  So, at least in my case, non-nerve sparing did not equate with incontinence problems. 
I also don't know what "focal perineural invasion" means.  Sorry.

Veteran Member

Date Joined Apr 2008
Total Posts : 847
   Posted 5/11/2011 4:21 PM (GMT -6)   
"Nerve-sparing" is all to do with the erectile nerves, and is independent of the urinary sphincter nerves.

I was non-nerve-spared and was fully continent from the day the catheter came out. As expected, I had (and still have) ED, but it's not so bad :-)

Some guys here have only one side spared and are fully functional (with erections) from day one. Others have both sides "spared" and never recover. What ultimately happens is very variable, and it's impossible to predict individual cases.

I'll have a shot at defining "focal perineural invasion" -- if I have anything wrong, I'm sure a more knowledgeable member will correct me:

Perineural invasion is where the PCa invades the internal nerves of the prostate. These nerves are the path of least resistance, so perineural invasion is the norm. The definition of "focal" means it is confined to just a few places, so I would take that as a good sign.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4/12 cores
Non-nerve-sparing RRP 7 March 2008 age 63
Organ confined, neg margins. Gleason downgrade 4+4=8
Fully continent
Bimix worked well; now using just VED
PSA undetectable at first but then rose to 0.4, doubling time 7 months
Following diet change, PSA static at 0.4...

Post Edited (Piano) : 5/11/2011 5:25:49 PM (GMT-6)

Regular Member

Date Joined Dec 2010
Total Posts : 55
   Posted 5/11/2011 5:42 PM (GMT -6)   
I had non-nerve sparring surgery and have not really had an issue with incontinence since catheter removal. ED function is a problem and I have started a regimen of daily ciallis (well every other day) with some results. No full erection yet, but I have become a shower, not a grower. LOL
Age 45
Jul 2010 - PSA 10.1
Aug 2010 - Biopsy - 12 of 12 cores positive - Gleason 7 (3+4 on the right, 4+3 on the left)
Sept 2010 - CAT and Bone scans negative.
Nov 2010 - da vinci RP with negative margins. nerve bundles were not spared. negative lymph nodes. Pathology Stage pT3c.
Jan 2011 - PSA undetectable
Apr 2011 - Started ART - 37 sessions
Apr 2011 - PSA undetectable

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2461
   Posted 5/11/2011 6:05 PM (GMT -6)   
I had non-nerve sparing and haven't had incontinence problems sine the 4th month after surgery. I have ED problems that seem to be slowly improving but not enough.
Age: 67 at Dx on 12/30/08 PSA 3.8
2 cores out of 12 were positive Gleason (4+4)
Davinci surgery 2/9/09 Gleason 4+4 EPE,
Margins clear, nerve bundles removed
Prostate weighed 57 grams 10-20% involved
all PSA tests since (2, 5, 8, 11, 15, 18, 21, 2 years <.008? ) undetectable
27 months: .005
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