Nerve-sparing prostatectomy: an American or a European discovery? probable

Positions

1. Walsh's clue and operation

   A potent patient in 1977 led Walsh to question the belief that the nerves of erection ran through the prostate; he designed and performed the first nerve-sparing operation on 26 April 1982.

   Sources

   1. Johns Hopkins Medicine 2020: 40th anniversary of a lifesaving discovery Secondary
   2. OncLive: Walsh's quest to understand male anatomy Secondary

2. Donker's anatomy

   EAU Today asks whether the operation was a European discovery, stressing that Donker's dissection of a stillborn infant in Leiden located the nerves, with Walsh, in three hours.

   Sources

   1. EAU Today: Nerve-sparing radical prostatectomy, a European discovery? Museum or society dead link

Evidence

The sources agree on the facts: the two men found the nerves together in Donker's laboratory on 13 February 1981, and published together in 1982. Hopkins also credits the operation with a rise in surgery among men in their fifties from 7% to 70% between 1982 and 1992, and links it to a 30% fall in deaths by 2002; that causal claim is contestable, since PSA screening and other treatments also changed.

Current standing

A two-man discovery. Whether nineteenth-century anatomists had described these nerves without surgeons noticing is not established in the kit.

All sources