Evidence mapPaperPMID 41847443Full record

ArticleResearch and reports in urology2026

Preserving Neurovascular Bundles Preserves the Mind: Cognitive, Functional, and Quality-of-Life Outcomes of Nerve-Sparing Radical Prostatectomy.

Bartosz Brzoszczyk, Alicja Popiołek, Piotr Jarzemski, Kinga Grzybowska, Wiktoria Tobolska, Filip Matusiak, Franciszek Domański, Alina Borkowska, Maciej Bieliński

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Article in Research and reports in urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Bartosz BrzoszczykClinic of Urology, Jan Biziel University Hospital No. 2, Nicolaus Copernicus University in Torun, Collegium Medicum, Poland.ORCID 0000-0002-7765-4059
Alicja PopiołekDepartment of Clinical Neuropsychology, Nicolaus Copernicus University in Torun, Collegium Medicum, Poland.
Piotr JarzemskiClinic of Urology, Jan Biziel University Hospital No. 2, Nicolaus Copernicus University in Torun, Collegium Medicum, Poland.ORCID 0000-0002-2727-3653
Kinga GrzybowskaChild and Adolescent Psychiatry Unit, Dr. J. Bednarz Psychiatric Hospital, Swiecie, Poland.
Wiktoria TobolskaClinic of Urology, Jan Biziel University Hospital No. 2, Nicolaus Copernicus University in Torun, Collegium Medicum, Poland.
Filip MatusiakClinic of Urology, Jan Biziel University Hospital No. 2, Nicolaus Copernicus University in Torun, Collegium Medicum, Poland.
Franciszek DomańskiClinic of Urology, Jan Biziel University Hospital No. 2, Nicolaus Copernicus University in Torun, Collegium Medicum, Poland.
Alina BorkowskaDepartment of Clinical Neuropsychology, Nicolaus Copernicus University in Torun, Collegium Medicum, Poland.ORCID 0000-0001-7305-0242
Maciej BielińskiDepartment of Cardiac Rehabilitation and Experimental Cardiology; Wladyslaw Bieganski's Regional Specialist Hospital, Grudziadz, Poland.ORCID 0000-0001-8345-7214

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Radical prostatectomy (RP) is a standard curative treatment for localized Prostate cancer (PCa), but may negatively affect health-related quality of life (HRQoL) through urinary incontinence, erectile dysfunction, psychological distress, cognitive decline. Neurovascular bundle (NVB)-sparing techniques aim to preserve functional outcomes; however, their effects on neurocognitive performance remain unclear. Purpose: This study evaluated the impact of bilateral NVB-sparing RP on cognitive function, psychological status, HRQoL, and biochemical recurrence in patients with PCa. Methods: This retrospective study included 100 Caucasian patients who underwent laparoscopic RP between 2017 and 2022, either with bilateral intrafascial NVB preservation or without NVB sparing, according to European Association of Urology criteria. All surgeries were performed by high-volume surgeons with experience exceeding 250 RPs each. Cognitive function was assessed using a standardized computer-based test. Psychological and functional status was evaluated with the HADS Scale, ICIQ-UI SF and IIEF5 scale. HRQoL was measured with the EORTC QLQ-C30 and PR25 questionnaires. Serum prostate-specific antigen (PSA) and testosterone levels were analyzed. Results: Patients undergoing NVB-sparing RP demonstrated faster reaction times and better visual working memory compared with the non-NVB-sparing group. Postoperative erectile function, urinary continence, and testosterone levels were significantly superior following NVB preservation. HRQoL outcomes favored NVB-sparing RP, including higher global health status, physical, emotional, and cognitive functioning, and reduced fatigue. Anxiety and depression scores were lower but did not reach statistical significance. Lower postoperative PSA and absence of biochemical recurrence were associated with better verbal memory and executive functioning. No significant differences in BCR rates were observed between groups. Conclusion: Bilateral NVB-sparing RP preserves urinary and sexual function while supporting cognitive performance and psychosocial well-being, resulting in improved HRQoL without increasing the risk of BCR. These findings confirm the oncological safety of NVB-sparing RP and support the inclusion of neurocognitive and quality-of-life outcomes in surgical decision-making for patients with prostate cancer.

Indexed as

anxietycognitiondepressionnerve sparing prostatectomyprostate cancersexual dysfunction

Identifiers

PMID41847443
PMCPMC12990793

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.