Feature in Focus: Neurovascular Bundle Detection Software to Preserve Potency

One of the reasons why men are so anxious about a prostate cancer diagnosis is the type of complications that can be common with traditional prostate cancer treatments. One of the most important complications men want to avoid after prostate cancer treatment is erectile dysfunction.

Due to the location of the prostate in the body, when it is surgically removed or when radiation is applied to it, the areas close by –specifically nerves near the prostate – can be damaged. These nerves, referred to as the neurovascular bundles (NVB), are responsible for preserving erectile function and if they are damaged during treatment, men may have long-term problems with achieving an erection for sexual activity.

Most men are not ready to give up their sex life even if they are dealing with a cancer diagnosis. Therefore, new techniques and technologies have been developed in order to spare damage to those nerves during prostate cancer treatments.

Some physicians offer a nerve-sparing radical prostatectomy, sometimes robotic, where the doctor tries to preserve the nerves while surgically removing the prostate. However, this type of procedure is heavily dependent on the ability of the physician performing the procedure as it takes a lot of experience for a surgeon to be able to determine exactly where it is possible to preserve the nerve bundles and where it should be removed.

While radiation has gotten more targeted with new technology, there is still a risk of radiation spreading to the nerves and damaging them.

Sonablate HIFU gives doctors a visual road map to be able to avoid damage to neurovascular bundles.

All of the Sonablate systems used by the HIFU Prostate Services team and doctors to deliver the HIFU treatment for prostate cancer are fully equipped with unique software that can detect the exact location of blood flow through the neurovascular bundles.

Once the blood flow is detected, the Sonablate software overlays the precise location of these nerve bundles on the ultrasound treatment images that the doctor uses to plan where he will deliver HIFU and destroy tissue.

This software aids the physician in avoiding the NVB’s during the treatment. This doesn’t guarantee a reduction in side effects, but being able to visualize the NVB’s does greatly reduce the chances of erectile dysfunction.

The data shows an improvement from 47.5%1 erectile dysfunction without NVB detection, to 11%2 (focal) – 28%3 (whole gland) for treatments with the NVB detection software.

1 Uchida et al. (2015). THE JOURNAL OF UROLOGY. Improved Outcomes with Advancements in High Intensity Focused Ultrasound Devices for the Treatment of Localized Prostate Cancer. Vol. 193, 103-110

2 Ahmed, HU. (2012). The Lancet Oncology. Focal Therapy for Localized Unifocal and Multifocal Prostate Cancer: A Prospective Development Study, 2045(12), 70121-3.

3 Uchida, T. (2012). 11th International Symposium on Therapeutic Ultrasound. AIP Conf. Proc. Twelve Years’ Experience with High-Intensity Focused Ultrasound (HIFU) Using Sonablate Devices for the Treatment of Localized Prostate Cancer. 1481, 401-406.

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