Use of NeuroSAFE to guide nerve-sparing surgery results in improvement in erectile function at 12 months and urinary continence at three months
By Elana Gotkine HealthDay Reporter
THURSDAY, April 3, 2025 (HealthDay News) — Use of the NeuroSAFE technique, a standardized frozen section analysis that enables accurate real-time detection of positive surgical margins during nerve sparing in robot-assisted radical prostatectomy (RARP), improves patient-reported erectile function, according to a study published online March 24 in The Lancet Oncology.
Eoin Dinneen, Ph.D., from University College London, and colleagues examined the effect of NeuroSAFE-guided RARP versus standard RARP on erectile function and urinary continence in a multicenter, randomized phase 3 trial. Patients with a diagnosis of nonmetastatic prostate cancer deemed suitable to undergo RARP with good erectile function and no previous prostate cancer treatment were enrolled and randomly allocated to standard RARP or NeuroSAFE-guided RARP (191 and 190 patients, respectively).
The researchers found that among the 344 patients in whom data were available at 12 months, the scores on the first five items of the International Index of Erectile Function (IIEF-5) were 12.7 and 9.7 in the NeuroSAFE group (173 patients) and standard RARP group (171 patients), respectively. The International Consultation on Incontinence Questionnaire (ICIQ) score was significantly lower in the NeuroSAFE group than the standard RARP group at three months (adjusted mean difference, −1.41). No significant difference in ICIQ score was seen between the groups at six months. The mean score on the IIEF-6 was higher in the NeuroSAFE group than the standard RARP group at 12 months (15.3 versus 11.5). Serious adverse events occurred in 3 percent of patients in both the NeuroSAFE and the standard RARP groups.
“These findings should inform guideline updates and confirm the role of the NeuroSAFE technique as an adjunct to guide nerve-sparing,” the authors write.
One author disclosed ties to Intuitive Surgical.
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