Radical nerve-sparing prostatectomy: the first 30 patients treated with epidural anesthesia.

From August 1985 to January 1987, 30 patients were treated with radical nerve-sparing prostatectomy with epidural anesthesia. Transrectal ultrasound evaluation was available for the vast majority of these patients. Utilizing the anatomic techniques of early dorsal vein ligation, hypogastric artery control, and epidural anesthesia, blood loss was kept to a minimum, with 22 patients requiring no transfusions in this series. In addition, with the use of ultrasound, PSA (prostatic-specific antigen) determination, and pelvic CAT scan, 22 of the 30 patients (75%) had organ-confined disease. Twenty patients were potent preoperative and 14 are potent postoperative, for a potency rate of 70%.