IMPACT OF NERVE FUNCTION PRESERVATION TECHNIQUES IN PROSTATE CANCER SURGERIES: A CRITICAL REVIEW

Abstract

Nerve function preservation during prostate cancer surgery is a significant advance in urological practice, with the aim of improving patients’ quality of life, especially with regard to erectile function. This critical review evaluates the impact of nerve function preservation (NFP) techniques in prostate cancer surgery, examining the efficacy of bilateral and unilateral nerve approaches, and the influence of robotic-assisted technology on functional preservation. The review included recent studies on the functional and oncological outcomes associated with these techniques. The results indicate that bilateral nerve preservation, particularly when performed with robotic technology, results in better functional outcomes, such as higher rates of erectile function preservation. However, the analysis revealed a potential increase in the incidence of positive surgical margins (PSM) associated with NFP, which may impact oncological outcomes. The variability in protocols and the predominance of observational studies highlight the need for randomized clinical trials to provide more robust evidence. The review concludes that although preservation of nerve function is beneficial for patients' quality of life, a careful balance between functional preservation and oncological efficacy is crucial to optimize clinical outcomes.