Dorsal penile nerve cut and then repaired

  Dorsal penile nerve amputation is the cutting of 0.5-2 cm nerve (most hospitals do this now). Repairing this nerve is not difficult for orthopedic and hand surgeons, it is as easy as repairing the finger nerve in broken finger replantation , if there is a defect after removal of a section of the nerve a nerve graft must be done, both commonly used to repair the peroneal nerve. This donor area was used 70 years ago and has no functional problems, only a small area of numbness outside the dorsum of the foot. The most widespread application of this nerve in urologic repair today is radical nerve repair for prostate cancer.  During surgery, the two severed nerves are simply released and the length in between after natural retraction is the length of the defect. There is no need to excessively lengthen the cut length, as the result is the same as if it were not excessively lengthened. Generally, the cut nerve has a natural retraction of 20-30%, so the natural length without tension is sufficient, including the reserved length. However, deep fascial reduction must also be done during surgery to prevent erection from pulling the nerve anastomosis. Sexual intercourse is usually possible after 6 weeks after surgery, and oral nerve-nourishing drugs can be taken after January. The commonly used drugs are Micronutrients and vitamin B1, which are usually taken for 3 months.  The restoration of sensation in the glans immediately after the repair is common in finger replantation. This phenomenon is common in finger replantation. It is mainly due to the fact that the transplanted nerve is still active and has sensory transmission function. This phenomenon disappears immediately afterwards and gradually returns to glans sensation until 6-14 months after surgery. During this long period of time there is a little change that the patient may find difficult to appreciate. If part of the small nerve is cut, the numbness is not very contrasting and there is a little recovery that he may not appreciate. However, some people think that the repair is ineffective, which is a prejudice. On the contrary, if the nerve trunk is cut and repaired, the difference in sensation is very large, and the patient can easily experience the change.  Regarding the timing of surgical repair, it is currently believed that the earlier the better. In some patients who came for repair 6 days after the cut, there was no change in the severed end of the cut nerve, so the repair was easy and the recovery was fast and effective. The later the repair is done, the more the distal end of the cut nerve atrophies, which is detrimental to the repair, the slower the recovery, the poorer the result, and the lower the recovery percentage.  The nerve graft has two nerve anastomoses and the nerve grows slowly, so it takes 3-6 months to cross one anastomosis, so it takes a long time to wait after repair. If the nerve can be anastomosed directly, this is the best result, but the previous surgery was to remove a section of the nerve that could not be anastomosed directly to the end, and even if it was, it would definitely break during erection.