Improved patient-reported functional outcomes after nerve-sparing radical prostatectomy by using NeuroSAFE technique

Area of Science:

• Urology
• Oncology
• Surgical Innovation

Background:

• Nerve-sparing radical prostatectomy (NS-RP) aims to preserve post-operative erectile function and urinary control.
• Intra-operative frozen section examination (NeuroSAFE) is a technique used during NS-RP.
• The impact of NeuroSAFE on functional outcomes following NS-RP requires further investigation.

Purpose of the Study:

• To evaluate the effect of NeuroSAFE application during NS-RP on post-operative erectile function.
• To assess the influence of NeuroSAFE on urinary control after NS-RP.
• To compare functional outcomes between men undergoing NS-RP with and without NeuroSAFE.

Main Methods:

• A comparative study analyzing pre- and post-operative sexual function and urinary incontinence using EPIC-26.
• Two patient cohorts were analyzed: 95 men from the NeuroSAFE Group (Martini-Klinik) and 312 from the Non-NeuroSAFE Group (Oslo University Hospital).
• Patients underwent NS-RP for ≤cT2 prostate cancer with intra-prostatic tumors, with statistical significance set at p < 0.05.

Main Results:

• The NeuroSAFE Group demonstrated significantly better sexual outcomes compared to the Non-NeuroSAFE Group (p < 0.01).
• In pre-operatively potent men, erectile function was preserved in 74% of the NeuroSAFE Group versus 46% in the Non-NeuroSAFE Group (p < 0.01).
• NeuroSAFE showed limited superior effect on urinary continence; age and pre-operative sexual function were significant co-variables.

Conclusions:

• The application of NeuroSAFE during NS-RP contributes to the preservation of post-operative erectile function.
• The study suggests NeuroSAFE should be considered in NS-RP procedures to maximize sexual function preservation.
• Further confirmation in randomized controlled trials is recommended to validate these findings.