A breakthrough in prostate cancer surgery gives erectile function hope.

 A breakthrough in prostate cancer surgery gives erectile function hope.

A more advanced prostate cancer surgery technique nearly doubles the likelihood of men retaining erectile function compared to standard procedures, according to the first comprehensive trial of the approach.

Doctors at five UK hospitals evaluated the technique, which aims to preserve key nerves in the outer layer of the prostate believed to be crucial for erectile function.

Known as NeuroSafe, the procedure involves analyzing prostate tissue removed during surgery in real-time. If tests confirm the cancer has been fully removed, surgeons can preserve the nerve-rich outer layer, reducing the risk of erectile dysfunction.

Prof. Greg Shaw, the trial lead and consultant urologist at University College London Hospitals NHS Foundation Trust, explained: “This technique provides immediate feedback during surgery, allowing surgeons to confidently preserve as many nerves as possible and improve men’s chances of regaining sexual function post-surgery.”

Prostate cancer is the most common cancer in men in England, with 50,000 diagnoses annually. Globally, nearly 1.5 million men are diagnosed each year, with 375,000 deaths. The disease, often symptomless in its early stages, is particularly prevalent in men over 50.

Advancements in robotic surgery have enabled precision “nerve-sparing” techniques, allowing surgeons to remove the prostate while preserving surrounding nerves. However, ensuring no cancer cells remain is challenging. In cases of advanced cancer, surgeons typically remove the entire prostate, including its outer layers, to minimize the risk of recurrence.

With the NeuroSafe approach, surgeons remove the prostate while preserving as much nerve tissue as possible. They then freeze and stain slices of the removed prostate for immediate cancer analysis. If cancer cells are detected at the prostate’s surface, additional tissue may be removed. If the tumor is contained, the procedure is completed without affecting the surrounding nerves.

The trial involved 344 men with prostate cancer and no prior history of erectile dysfunction. Half underwent the NeuroSafe procedure, while the other half received standard surgery. One year post-surgery, 56% of men who had standard surgery reported severe erectile dysfunction, compared to 38% of those who had NeuroSafe surgery.

Additionally, 39% of men who had NeuroSafe surgery reported mild or no erectile dysfunction, compared to just 23% in the standard surgery group. The findings were presented at the 2025 European Association of Urology Congress in Madrid and published in The Lancet Oncology.

Dr. Matthew Hobbs, Director of Research at Prostate Cancer UK, called the study “promising,” noting that while prostate cancer surgery is often life-saving, side effects such as erectile dysfunction remain a major concern. “This research suggests innovative surgical techniques can help reduce these side effects, but further studies are needed to confirm whether NeuroSafe is as effective as traditional surgery in fully eliminating cancer.”

He also emphasized the need to determine which patients would benefit most from NeuroSafe and whether it could be widely implemented across the NHS to ensure accessibility for men throughout the UK.