EVERiST: Erectile Function Recovery After Bilateral Neurovascular Bundle Sparing Robot-Assisted Radical Prostatectomy With or Without Accessory Pudendal Artery Detected by Multiparametric MRI: A Feasibility Study

What this Trial Is About

Prostate cancer is the most common cancer among men in the UK, with treatments including surgery to remove the prostate or radiotherapy. Both can affect quality of life, mainly due to erectile dysfunction and urinary leakage. This study explores whether preserving an accessory pudendal artery (APA), an extra artery found in up to one in three men, during nerve-sparing robotic prostate surgery improves recovery of erectile function. The research focuses on men with good baseline sexual function undergoing robotic surgery at University College London Hospital. Participants will have preoperative multiparametric MRI scans to detect the presence of an APA and robotic surgery videos will be reviewed to see if the artery was preserved. Up to 40 men aged 18 to 79 with localized prostate cancer and good baseline erectile function will be included. Follow-up includes questionnaires on erectile function and quality of life at baseline, 6 weeks, 6 months, and 12 months after surgery. Additional imaging like a 3-month postoperative MRI and optional penile Doppler ultrasound will be performed for those with an APA. Participants will undergo regular assessments including patient-reported outcome measures and imaging tests to evaluate erectile function recovery. The study will also review surgical videos to assess preservation of the APA. The main outcomes include recruitment feasibility, follow-up completion, and identification of the APA on MRI scans. This feasibility study aims to inform a larger trial that could improve surgical approaches and patient counseling for prostate cancer treatment.

EVERiST: Impact of Image Detected Accessory Pudendal Artery on Erection Recovery After Nerve Sparing Prostatectomy