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Does it make sense to preserve the neurovascular bundles?

Not in all cases does it make sense to preserve the neurovascular bundles. The issue here relates to the physical proximity of the bundles to areas of malignancy, which can microscopically extend beyond the prostate and into the bundles. Furthermore, in men with poor erectile function, there is no known value to nerve preservation, which requires more effort and operative time. As with pelvic lymph nodes, the decision to preserve one or both neurovascular bundle depends on an individual analysis of baseline function and the chance to regain function post prostate surgery, the importance of maintaining erections, and the risks of leaving cancer behind.