A technique to improve the precision of prostate cancer surgery means that almost twice as many men preserve their erectile function compared to those undergoing standard surgery, according to results from a clinical trial led by researchers from UCL and UCLH.
The results of the NeuroSAFE PROOF trial, presented at the 2025 European Association of Urology (EAU) Congress in Madrid and published in The Lancet Oncology, raise the prospect of major quality of life improvements for men undergoing surgery for prostate cancer, which can often result in erectile dysfunction and urinary incontinence.
The trial evaluated a method called NeuroSAFE which preserves the nerves that run through the prostate’s outer layers during prostate removal. These nerves are thought to be responsible for producing erections. The pioneering method includes an additional test to ensure that all of the cancerous cells are removed, so that preserving the nerves does not risk the surgery’s success.
UCLH consultant urologist Professor Greg Shaw said: “Our results show that, by using NeuroSAFE, nearly twice as many men don’t have to face potentially life-changing loss of erectile function after prostate surgery. It is an involved procedure that requires expertise, but it isn’t expensive, particularly given the benefits it offers for patients, and most importantly doesn’t jeopardise cancer control.
“NeuroSAFE wouldn’t be appropriate for all patients, as many can safely have nerve-sparing surgery using standard robotic techniques. But for younger patients and those who wouldn’t normally be seen as eligible for nerve-sparing surgery, it offers them a greater chance to hold onto their quality of life.”
The NeuroSAFE PROOF trial is the first randomised, controlled trial to fully evaluate the impact of the NeuroSAFE technique on erectile dysfunction and urinary incontinence – two of the most common side effects of prostate surgery.
The study was funded by the National Institute for Health and Care Research, The Rosetrees Foundation, St Peter’s Charitable Trust and the Jon Moulton Charity Trust.
The Biostatistics Group within the JRO assisted with statistical analysis in the study.
