Table 1.
Neurovascular bundles: nerve-sparing technique
| Author | Classification | Description |
|---|---|---|
| Waltz et al. 2010 [30] | Intrafascial dissection | Intrafascial dissection of the NVB is considered a dissection that follows a plane on the prostate capsule, remaining medial or internal to the PF at the anterolateral and posterolateral aspect of the prostate and also remaining anterior to PPF/SVF |
| Interfascial dissection | Interfascial dissection of the NVB is considered a dissection outside or lateral to the PF at the anterolateral and posterolateral aspects of the prostate combined with a dissection medial to the NVB at the 5-o’clock and 7-o’clock positions or the 2-o’clock and 10-o’clock positions of the prostate in axial section | |
| Extrafascial dissection | Extrafascial dissection of the NVB (non-NS) is considered a dissection-carried lateral to the LAF and posterior to the PPF/SVF. In this case, the NVB running along the posterolateral aspect of the prostate is completely resected with LAF, PF, and PPF/SVF remaining on the prostate | |
| Montorsi et al. 2012 [31] | Full | Full dissection of the NVB is considered a dissection between the prostatic capsule and the multilayer tissue of the prostatic fascia |
| Partial | Partial dissection of the NVB is considered a dissection within the multilayer tissue of prostatic fascia | |
| Minimal | Minimal dissection of the NVB is considered a dissection aimed to preserve only the cavernous nerves running at the posterolateral surface of the prostate | |
| Tewari et al. 2011 [32] | Grade 1 | Grade 1 dissection of the NVB is considered a dissection of the Denonvilliers’ and lateral pelvic fascia (LPF) just outside the prostatic capsule. |
| Grade 2 | Grade 2 dissection of the NVB is considered a dissection through the Denonvilliers’ (leaving deeper layers on the rectum), and LPF is taken just outside the layer of veins of the prostate capsule | |
| Grade 3 | Grade 3 dissection of the NVB is considered a dissection through the outer compartment of the LPF (leaving some yellow adipose and neural tissue on the specimen), excising all layers of Denonvilliers’ fascia | |
| Grade 4 | Grade 4 dissection of the NVB (non-NS) is considered a dissection of the LPF and Denonvilliers’ fascia containing most of the periprostatic neurovascular tissue | |
| Schatloff et al. 2012 [33] | Grade 5 | Grade 5 (≥ 95%) dissection of the NVB is considered a dissection performed medial to LA just outside the prostatic fascia at the pearly areolar tissue between the prostate and the NVB |
| Grade 4 | Grade 4 (75%) dissection of the NVB is considered a dissection performed using a sharp dissection at a plane between the LA and the prostatic capsule across the NVB—not at the pearly areolar plane, as in the case of a complete NS | |
| Grade 3 | Grade 3 (50%) dissection of the NVB is considered a dissection at the artery’s lateral aspect; therefore, the LA is clipped at the level of the prostatic pedicle | |
| Grade 2 | Grade 2 (< 50%) dissection of the NVB is considered a dissection performed several millimeters lateral to the artery, following the prostatic contour | |
| Grade 1 | Grade 1 (0%) dissection of the NVB (non-NS) is considered a dissection performed by sequentially clipping below the prostate across the NVB. The prostate is lifted up and only rotated when approximating the apex as the pelvis gets narrow and the NVB curves in the direction of the perineum |