{"id":32790,"date":"2026-09-11T18:14:00","date_gmt":"2026-09-11T22:14:00","guid":{"rendered":"https:\/\/www.rigicon.com\/?post_type=glossary-term&p=32790"},"modified":"2026-09-12T06:04:00","modified_gmt":"2026-09-12T10:04:00","slug":"cirurgia-com-preservacao-nervosa","status":"publish","type":"glossary-term","link":"https:\/\/www.rigicon.com\/pt-br\/glossary-term\/cirurgia-com-preservacao-nervosa\/","title":{"rendered":"Cirurgia com Preserva\u00e7\u00e3o Nervosa"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":0,"template":"","glossary-category":[112],"glossary-product":[104,105],"class_list":["post-32790","glossary-term","type-glossary-term","status-publish","hentry","glossary-category-surgical-procedures","glossary-product-infla10-pulse-ipp-series","glossary-product-rigi10-malleable-penile-prosthesis"],"acf":{"gt-definition":"

A cirurgia com preserva\u00e7\u00e3o nervosa \u00e9 uma t\u00e9cnica cir\u00fargica especializada que busca preservar os feixes neurovasculares pr\u00f3ximos aos tecidos removidos durante a prostatectomia radical.1<\/span> Este procedimento visa especificamente proteger as bainhas dos nervos cavernosos localizadas logo abaixo e nas laterais da pr\u00f3stata, respons\u00e1veis pela fun\u00e7\u00e3o er\u00e9til.2<\/span> Os feixes neurovasculares cont\u00eam nervos, art\u00e9rias, veias e canais linf\u00e1ticos que controlam o fluxo sangu\u00edneo para o p\u00eanis e iniciam as ere\u00e7\u00f5es.3<\/span> Durante uma prostatectomia com preserva\u00e7\u00e3o nervosa, os cirurgi\u00f5es separam meticulosamente a pr\u00f3stata dessas delicadas estruturas nervosas, utilizando t\u00e9cnicas de dissec\u00e7\u00e3o precisas para minimizar os danos neurais e, ao mesmo tempo, obter a remo\u00e7\u00e3o completa do tumor.4<\/span> Essa abordagem \u00e9 particularmente valiosa no tratamento do c\u00e2ncer de pr\u00f3stata, onde a preserva\u00e7\u00e3o da fun\u00e7\u00e3o sexual \u00e9 uma preocupa\u00e7\u00e3o significativa para a qualidade de vida dos pacientes ap\u00f3s a cirurgia.5<\/span><\/p>\n","gt-synonyms":"Prostatectomia radical com preserva\u00e7\u00e3o nervosa, NS-RARP (Prostatectomia Radical Assistida por Rob\u00f4 com Preserva\u00e7\u00e3o Nervosa), Prostatectomia com preserva\u00e7\u00e3o de nervos, Prostatectomia com preserva\u00e7\u00e3o da pot\u00eancia, Cirurgia com preserva\u00e7\u00e3o dos nervos cavernosos","gt-citation":"[1] National Cancer Institute. Definition of nerve-sparing surgery - NCI Dictionary of Cancer Terms. https:\/\/www.cancer.gov\/publications\/dictionaries\/cancer-terms\/def\/nerve-sparing-surgery\n\n[2] Kumar A, Patel VR, Panaiyadiyan S, Bhat KRS, Moschovas MC, Nayak B. Nerve-sparing robot-assisted radical prostatectomy: Current perspectives. Asian J Urol. 2021;8(2):194-208. DOI: 10.1016\/j.ajur.2020.05.012\n\n[3] Catalona WJ. Dr. Catalona Discusses Nerve-Sparing Surgery. QUEST (Winter 2002). https:\/\/drcatalona.com\/quest\/dr-catalona-discusses-nerve-sparing-surgery\/\n\n[4] Spirito L, Chessa F, Hagman A, et al. Long-Term Oncological Outcomes after Nerve-Sparing Robot-Assisted Radical Prostatectomy for High-Risk Localized Prostate Cancer: A Single-Center, Two-Arm Prospective Study. Diagnostics. 2024;14(8):803. DOI: 10.3390\/diagnostics14080803\n\n[5] Morozov A, Plata C, Gilani N, et al. A systematic review of nerve-sparing surgery for high-risk prostate cancer. World J Urol. 2021;39(9):3443-3453. DOI: 10.1007\/s00345-021-03594-9","gt-clinical-context":"

A cirurgia com preserva\u00e7\u00e3o nervosa \u00e9 utilizada principalmente no contexto da prostatectomia radical para o tratamento do c\u00e2ncer de pr\u00f3stata localizado.1<\/span> A sele\u00e7\u00e3o de pacientes para esta t\u00e9cnica \u00e9 cr\u00edtica e depende de diversos fatores, incluindo fun\u00e7\u00e3o er\u00e9til pr\u00e9-operat\u00f3ria, idade, caracter\u00edsticas do tumor e estadiamento do c\u00e2ncer.2<\/span> O procedimento \u00e9 mais apropriado para pacientes com doen\u00e7a confinada ao \u00f3rg\u00e3o (est\u00e1gio cl\u00ednico T1-T2), onde o c\u00e2ncer n\u00e3o se estendeu al\u00e9m da c\u00e1psula prost\u00e1tica.3<\/span><\/p>\n

A avalia\u00e7\u00e3o pr\u00e9-operat\u00f3ria geralmente inclui toque retal, n\u00edveis de ant\u00edgeno prost\u00e1tico espec\u00edfico (PSA), resultados de bi\u00f3psia e, frequentemente, resson\u00e2ncia magn\u00e9tica multiparam\u00e9trica para avaliar o risco de extens\u00e3o extracapsular.4<\/span> De acordo com as diretrizes atuais da European Association of Urology, a cirurgia com preserva\u00e7\u00e3o nervosa deve ser realizada quando h\u00e1 baixo risco de extens\u00e3o extracapsular, embora uma sele\u00e7\u00e3o criteriosa possa permitir seu uso em alguns casos de maior risco.5<\/span><\/p>\n

A abordagem cir\u00fargica pode ser realizada por meio de t\u00e9cnicas retrop\u00fabica aberta, laparosc\u00f3pica ou assistida por rob\u00f4, sendo que esta \u00faltima oferece melhor visualiza\u00e7\u00e3o e precis\u00e3o.6<\/span> Durante o procedimento, os cirurgi\u00f5es devem identificar e preservar cuidadosamente os feixes neurovasculares que correm posterolateralmente \u00e0 pr\u00f3stata. A dissec\u00e7\u00e3o pode ser intrafascial (permanecendo interna \u00e0 f\u00e1scia prost\u00e1tica) ou interfascial (entre a f\u00e1scia prost\u00e1tica e a f\u00e1scia p\u00e9lvica lateral), com a primeira oferecendo m\u00e1xima preserva\u00e7\u00e3o nervosa, mas com risco potencialmente maior de margens cir\u00fargicas positivas.7<\/span><\/p>\n

No p\u00f3s-operat\u00f3rio, os pacientes podem apresentar disfun\u00e7\u00e3o er\u00e9til tempor\u00e1ria enquanto os nervos se recuperam do trauma cir\u00fargico, com a fun\u00e7\u00e3o podendo melhorar ao longo de 6 a 36 meses.8<\/span> Estudos demonstraram que homens submetidos \u00e0 prostatectomia com preserva\u00e7\u00e3o nervosa t\u00eam chances significativamente maiores de recuperar a fun\u00e7\u00e3o er\u00e9til em compara\u00e7\u00e3o com abordagens sem preserva\u00e7\u00e3o nervosa, com taxas de pot\u00eancia \u226550% relatadas em pacientes cuidadosamente selecionados.9<\/span> Al\u00e9m disso, algumas evid\u00eancias sugerem melhores resultados de contin\u00eancia urin\u00e1ria com t\u00e9cnicas de preserva\u00e7\u00e3o nervosa.10<\/span><\/p>\n","gt-related-evidence":null,"gt-featured":true,"gt-ai-referenced":true,"gt-view-count":2},"yoast_head":"\nCirurgia com Preserva\u00e7\u00e3o Nervosa da Pr\u00f3stata<\/title>\n<meta name=\"description\" content=\"A cirurgia com 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