Lancet Oncol

Prostatectomy with nerve-sparing technique preserves erectile function

April 2, 2025

Study details: The phase 3, multicenter, patient-blinded, randomized, controlled NeuroSAFE PROOF trial, conducted at five hospitals in the U.K., compared NeuroSAFE-guided robot-assisted radical prostatectomy (RARP) with standard RARP in 407 patients with localized prostate cancer. Participants were randomly assigned to either standard RARP or NeuroSAFE-guided RARP, with the primary outcome being erectile function at 12 months, assessed using the International Index of Erectile Function (IIEF-5) score.

Results: At 12 months, the mean IIEF-5 score was significantly higher in the NeuroSAFE group (12.7) compared with the standard RARP group (9.7), with an adjusted mean difference of 3.18. Additionally, the NeuroSAFE group had better urinary continence at 3 months, with a lower International Consultation on Incontinence Questionnaire (ICIQ) score. No significant difference in ICIQ scores was observed at 6 months. The mean IIEF-6 score at 12 months was also higher in the NeuroSAFE group (15.3 vs. 11.5).

Clinical impact: The NeuroSAFE technique during RARP significantly improves erectile function and early urinary continence in patients with localized prostate cancer. This approach may be particularly beneficial for patients who wouldn't typically undergo bilateral nerve-sparing procedures, enhancing their postoperative quality of life without increasing adverse events.

Source:

Dinneen E; NeuroSAFE PROOF Investigators; et al. (2025, March 18). Lancet Oncol. Effect of NeuroSAFE-guided RARP versus standard RARP on erectile function and urinary continence in patients with localised prostate cancer (NeuroSAFE PROOF): a multicentre, patient-blinded, randomised, controlled phase 3 trial. https://pubmed.ncbi.nlm.nih.gov/40147459/