NeuroSAFE results show enhanced precision preserves erectile function
According to the NeuroSAFE PROOF trial results presented at EAU25, NeuroSAFE-guided RARP enhances traditional nerve-sparing robotic surgery by incorporating an intraoperative assessment, significantly improving surgical precision for patients with localised prostate cancer. As a result, nearly twice as many men preserve their erectile function compared to those undergoing standard RARP.
The NeuroSAFE procedure allows surgeons to determine whether preserving the prostate’s outer nerve layers is safe without compromising cancer removal. As Prof. Greg Shaw (GB) explained, “By using NeuroSAFE, nearly twice as many men don’t have to face potentially life-changing loss of erectile function after prostate surgery.” He emphasised that while the procedure requires expertise, it is not costly and does not compromise cancer control.
The trial involved 344 men with prostate cancer who had no prior erectile dysfunction. They were randomly assigned to undergo either NeuroSAFE or standard surgery. One year post-surgery, 39% of NeuroSAFE patients had no or mild erectile dysfunction, compared to just 23% in the standard surgery group. Furthermore, only 38% of NeuroSAFE patients experienced severe erectile dysfunction, compared to 56% in the standard group.
While NeuroSAFE did not significantly improve overall urinary continence rates at 12 months, those who regained control did so more quickly.
NeuroSAFE has been widely used in Germany for over a decade, but this is the first randomised trial to validate its benefits. Experts believe further trials could confirm its long-term impact on cancer control and post-surgical recovery.