NeuroSAFE Increases Erectile Function After Prostate Cancer Surgery

Researchers have found that the use of the NeuroSAFE technique to guide nerve sparing during robot-assisted radical prostatectomy (RARP) improved patient-reported erectile function among patients with prostate cancer, study results have shown.

Findings from the NeuroSAFE PROOF phase 3 trial, conducted at five National Health Service Hospitals in the United Kingdom, were published in The Lancet Oncology and presented at the 2025 European Association of Urology Congress in Madrid.

“In summary, this trial confirms the efficacy of the NeuroSAFE technique to improve functional outcomes after RARP in patients with good preoperative urinary and erectile function,” Dr. Greg Shaw and colleagues wrote in The Lancet Oncology. “These findings should inform guideline updates and confirm the role of the NeuroSAFE technique as an adjunct to guide nerve-sparing.”

Shaw is the lead for robotic urology for University College London Hospitals and a professor of urology at University College London.

NeuroSAFE, which has been used in Germany for more than a decade, allows surgeons to determine whether preserving the prostate’s outer nerve layers is safe without compromising cancer removal, as the European Association of Urology explained on its website.

Among 344 patients who underwent surgery for prostate cancer — 173 in the NeuroSAFE group and 171 in the standard RARP group at a median follow-up of 12.3 months — 39% of patients in the NeuroSAFE group had no or mild erectile dysfunction versus 23% of patients in the RARP group.

Shaw sat down for an interview with CURE to discuss the study and its findings.

Transcript:

The trial that we presented in Madrid, that coincided with the Lancet Oncology paper, is definitive evidence that the new technique that we trialed, the NeuroSAFE technique, allows us to help more men get back to potency after radical prostatectomy. Radical prostatectomy, as some of you will probably be aware, is an operation used to cure prostate cancer. It's really good for curing prostate cancer.

However, many men are left with side effects, [including] urinary incontinence and erectile problems. Using this technique, we doubled the number of men who were able to get normal erections after the procedure compared to our standard approach.

Transcript has been edited for clarity and conciseness.

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