Infrared Laser Nerve Stimulation as a Potential Diagnostic Method for Intra-Operative Identification and Preservation of the Prostate Cavernous Nerves

The cavernous nerves, which course along the surface of the prostate gland, are responsible for erectile function. Urologic surgeons are challenged in preserving these nerves during prostate cancer surgery, due to their microscopic nature and variable location among patients. Current intra-operative diagnostic methods for identifying, imaging, and preserving these delicate nerves during removal of a cancerous prostate gland remain sub-optimal. Our laboratory is focused on developing optical-based methods for detecting these nerves. This manuscript reviews progress in pre-clinical development of infrared optical nerve stimulation as a potential technique for identifying the cavernous nerves. Critical laser parameters for safe and reliable stimulation of the cavernous nerves, development of laser and fiber optic probe instrumentation, and novel approaches are presented.