EVERiST: Impact of Image Detected Accessory Pudendal Artery on Erection Recovery After Nerve Sparing Prostatectomy
Prostate cancer treatment can affect erections. Even with 'nerve-sparing' surgery, many men still have problems. This study explores if an extra blood vessel, called an accessory pudendal artery (APA), plays a role in erection recovery. About one in three men have an APA. The researchers will use special MRI scans taken before surgery to find these APAs. During robotic prostate surgery, they'll also record videos to see if the APA is protected. Afterwards, they’ll check if keeping this artery safe helps men get their erections back. The first stage of this research, a small study at University College London Hospital, will involve 20-40 men who have good erections before surgery. They will complete questionnaires, and some will have extra scans to check the artery after surgery. The results will help plan a bigger study to see if this approach could improve surgery and recovery for men with prostate cancer.
At a glance
What is this study about?
Prostate cancer is very common in men in the UK, and treatments like surgery to remove the prostate can be very effective. However, a big concern for many men is that these treatments can cause problems with erections and sometimes urinary leaks. This can be quite upsetting and affect their quality of life. Surgeons often try to protect the nerves during surgery to help preserve erections, but even then, many men still find their erections aren't as good as they were before.
This study is looking at whether an additional blood vessel, which we call the accessory pudendal artery (APA), could be important for erection recovery. Around one in three men have this extra artery. Researchers believe that if this artery can be protected during surgery, it might help improve blood flow to the penis and reduce the chances or severity of erection problems afterwards. Until recently, it was hard for surgeons to know if this artery was there or if it was protected during the operation. But now, special MRI scans that men have before prostate cancer treatment can show if they have an APA. Also, modern robotic surgery uses video recordings, so surgeons can see what happened during the operation and compare it with the scans.
This first part of the study is a small trial happening at University College London Hospital. It's designed to see if it's possible to accurately identify and track this artery. They will invite 20 to 40 men who are going to have robotic prostate surgery and already have good erections. The men will complete simple questionnaires about their erections before and after surgery for up to a year. For those found to have an APA, there will be extra scans after surgery to check if the artery was successfully preserved and how it's affecting their erections. The information gathered from this study will then help plan a larger national study to confirm if protecting this artery during surgery really does help men recover their erections, reduce problems, and improve their overall quality of life.
Key takeaways
- This study investigates if an extra blood vessel (APA) affects erection recovery after prostate cancer surgery.
- It uses existing MRI scans and robotic surgery videos to track this vessel.
- Researchers hope to find out if protecting the APA helps men regain erections.
- Participants will complete questionnaires and potentially have extra scans.
- The findings could lead to improved surgical methods and patient support in the future.
Who may be eligible?
This study is looking for men aged 18 to 79 who have recently been diagnosed with prostate cancer that hasn't spread beyond the prostate. You should be generally healthy enough for surgery and planning to have robotic surgery to remove your prostate, where the surgeon aims to protect the nerves that help with erections.
Crucially, you need to have good erections before your surgery. This means you don't already have moderate or severe problems with getting or keeping an erection. You also need to want to preserve your ability to have erections for sexual activity. You should be able to understand the study information and give your consent in English.
You would not be able to join the study if you've already had hormone therapy, previous prostate surgery, or other treatments for prostate cancer like radiotherapy. Also, if you have certain existing health conditions like significant heart, brain, or blood vessel diseases, or if you've had a broken pelvis or penis, or previous surgery for erection problems, you would not be eligible.
- Are you a man aged between 18 and 79 with prostate cancer?
- Are you having robotic surgery to remove your prostate, with nerves being spared?
- Do you have good erections (not moderate or severe problems) before your surgery?
- Do you want to preserve your erections for sexual activity?
- Have you not had any previous prostate cancer treatments or major vascular health issues?
This is a guide only — the research team will confirm whether you can take part.
What does participation involve?
If you join this study, you'll first have special MRI scans that look for the accessory pudendal artery before your robotic prostate surgery. The surgery itself will be recorded on video. You'll fill out simple questionnaires about your erections and general well-being before your surgery and then at several points over the next year after your surgery. If you have an accessory pudendal artery, you might be asked to have an extra MRI scan and a special ultrasound of your penis after surgery to check how the artery is doing and how blood is flowing. The total duration of your participation, including follow-up, will be up to one year after your surgery.
Potential risks and benefits
Locations (1)
- University College London Hospitals NHS foundation trustLondon, United Kingdom· Recruiting
Common questions
What is an accessory pudendal artery?
It's an extra blood vessel that some men have, which helps supply blood to the penis and might be important for erections.
Will this study change my prostate cancer treatment?
No, you will still receive the same robotic prostate surgery that your doctor has recommended. The study just gathers extra information about it.
Why am I filling out questionnaires?
These questionnaires help researchers understand how your erections and quality of life are changing after surgery.
Will I have extra tests if I join?
You'll have your usual MRI before surgery. If you have the extra artery, you might have an additional MRI and a special penis ultrasound after surgery.
What happens if I decide I don't want to be in the study anymore?
You can leave the study at any time, for any reason. Your decision won't affect the care you receive from your medical team.
How to find out more
Always speak to your GP or specialist before deciding to take part in a study.
Interested in taking part?
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