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The Independent
24-03-2025
- Health
- The Independent
Prostate cancer check doubles proportion of men who keep erectile function
A technique to preserve nerves during prostate cancer surgery almost doubles the proportion of men who keep erectile function, according to a new study. Compared to standard surgery, researchers said the new method could dramatically improve men's quality of life. Experts from University College London (UCL) and University College London Hospitals NHS Foundation Trust (UCL H) led the study, which will be presented at the European Association of Urology Congress in Madrid and published in the Lancet Oncology journal. It evaluated a method called NeuroSafe to preserve the nerves running through the prostate's outer layers, which are thought to be responsible for producing erections. During cancer surgery, the prostate is removed while the nerves are left intact. The prostate is then examined closely by a pathologist while the patient is still in surgery. The pathologist slices the area near to the nerves in 5mm strips, which are then quickly frozen and stained so they can be looked at through a microscope. The samples are analysed to see if any cancer cells are present. If there are none, the surgeons know that they can leave the patient's nerves intact in their body. If cancer is present, they know nerves will have to be removed. NeuroSafe happens in real-time during the operation, making it vastly different to traditional methods, where tissue samples are sent off and it takes two or three weeks to get results back. Professor Greg Shaw, trial lead from UCL and consultant urologist at UCLH, said some younger men in particular worry about surgery causing impotence and incontinence. He said: 'Our results show that, by using NeuroSafe, nearly twice as many men don't have to face potentially life-changing loss of erectile function after prostate surgery. 'It is an involved procedure that requires expertise, but it isn't expensive, particularly given the benefits it offers for patients, and most importantly doesn't jeopardise cancer control. 'NeuroSafe wouldn't be appropriate for all patients, as many can safely have nerve-sparing surgery using standard robotic techniques. 'But for younger patients and those who wouldn't normally be seen as eligible for nerve-sparing surgery, it offers them a greater chance to hold onto their quality of life.' Prof Shaw said the technology is not new but 'whereas before there wasn't evidence to support this approach, now we have the data to show that, actually, your outcomes are better'. Some 30% of the men in the study were from Afro Caribbean backgrounds. They tend to be diagnosed at a younger age with prostate cancer than white counterparts. The trial ran at five UK hospitals and included 344 men diagnosed with prostate cancer. Half were randomised to receive NeuroSafe during their operation and half had standard surgery. Twelve months after surgery, 39% of men in the NeuroSafe group had no or mild erectile dysfunction. In those men who had standard surgery, this was 23%. A year after their operation, only 38% of those who had surgery using NeuroSafe had severe erectile dysfunction, compared to 56% of men who had standard surgery. NeuroSafe patients who recovered their urinary control also did so faster than patients who underwent standard surgery. Prof Shaw now hopes more men will be able to access NeuroSafe on the NHS as long as the right pathology support is available. He told the PA news agency: 'Whether it can be rolled out or not depends on, I think, finding a good test that gives a similar result (to the pathologist's work) that's perhaps more easily performed, because it's quite complex. 'But the impetus for the community is you're doubling the chances of a man being potent afterwards. And that's compelling.' Dr Ricardo Almeida-Magana, from UCL, said: 'NeuroSafe offers surgeons a real-time evaluation of the safety of the procedure. 'In standard robotic surgery, surgeons determine whether to choose nerve sparing based on MRI scans, on digital rectal examinations and on biopsy results prior to surgery. 'But whereas those methods can provide guidance, NeuroSafe provides certainty. 'And that opens up the option of nerve-sparing surgery for many more men, without compromising on the chances of controlling the cancer.' Dr Matthew Hobbs, director of research at Prostate Cancer UK, said: 'A major challenge we face is how to cure men but also ensure they can live life to the full afterwards. 'This study is promising and provides evidence that innovative types of surgery can reduce erectile dysfunction in some men — however more research is needed to prove whether NeuroSafe is as effective as traditional techniques at delivering a complete cure. 'We also need to understand exactly which men could benefit from this new technique and, crucially, whether this technique could be delivered at scale across the NHS to make it accessible to men across the UK.'
The National
07-03-2025
- Health
- The National
Nasal surgery ‘kick starts' sense of smell for long Covid sufferers
Losing the sense of smell or taste was one of the peculiarities of the Covid-19 infection. For many long Covid sufferers, classed as those whose symptoms last more than three months, it has continued for years despite efforts to treat the problem. About 3 per cent to 5 per cent of sufferers develop long Covid, previous research by the University of Oxford found. Now, experts at University College London Hospitals NHS Foundation Trust (UCLH) have successfully used a technique for correcting blocked nasal passages on patients who have suffered a profound loss of smell after a Covid infection. One 27-year-old patient in the new UCLH study has had her sense of smell return almost to normal and is now expanding the range of foods she can eat. All patients taking part in the research had an impaired sense of smell for longer than two years and other treatment, such as smell training or corticosteroids, had failed The operation, known as functional septorhinoplasty (fSRP), is typically used to correct any deviation of the nasal septum, increasing the size of nasal passageways. This, in turn, increases the airflow into the roof of the nasal cavity, which controls smell. Researchers believe increasing the delivery of odorants (chemical compounds that have a smell) to this area 'kick starts' smell recovery in patients who have lost that sense due to long Covid. Penelope Newman, 27, from south London, took part in the trial. Her results have been published in the journal Facial Plastic Surgery. She said: 'Before I had the surgery on my nose, I had begun to accept that I would probably never be able to smell or taste things the way I used to. It seemed dire, and after around two and a half years of parosmia [impaired sense of smell], I had totally changed my lifestyle. 'For those who have experienced this, they will know how isolating it can be. The food I could cook and eat was so limited, and I couldn't go out to restaurants as I would feel unwell. Getting something as drastic as surgery was a risk I was willing to take, on the small chance it might help. 'Since the surgery, I have begun to enjoy food and smells the same way I used to. I can now cook and eat garlic and onions, and people can cook for me, too. I can go out to eat with my friends and family. 'My taste and smell have almost returned to normal," she added. "I'm not sure if it will ever fully return as I still have a small reduction in it, but I am so glad that I am no longer as isolated as I once was.' The new research was led by Prof Peter Andrews, senior consultant surgeon in rhinology and facial plastic surgery, and Alfonso Luca Pendolino, then-senior rhinology fellow at UCLH. It included 25 long Covid patients, with 12 of the patients undergoing fSRP, while the control group of 13 patients continued with smell training – sniffing the same scents repeatedly – for the study. Sense of smell was measured over the duration of the study by using the Sniffin' Sticks test, a widely used clinical test to detect smell. All patients who had fSRP reported an improved sense of smell compared with none of the patients in the sniff test group, where 40 per cent actually reported the sense worsening. The experts said the surgery was particularly good at increasing odour sensitivity by lowering the odour threshold – the minimal concentration of an odour a person can actually smell – which is specifically noted in long Covid patients with the impaired sense. Prof Andrews said sense of smell 'is bit like a muscle ... the more you use it, the stronger it is. Just like a muscle.' The surgery increases the airway by about 30 per cent, so air flow also increases by about 30 per cent.
The National
07-03-2025
- Health
- The National
Surgery solves long Covid sufferers sense of smell struggles
Losing the sense of smell or taste was one of the peculiarities of the Covid-19 infection. For many long Covid sufferers, classed as those whose symptoms last more than three months, it has continued for years despite efforts to treat the problem. About 3 per cent to 5 per cent of sufferers develop long Covid, previous research by the University of Oxford found. Now, experts at University College London Hospitals NHS Foundation Trust (UCLH) have successfully used a technique for correcting blocked nasal passages on patients who have suffered a profound loss of smell after a Covid infection. One 27-year-old patient in the new UCLH study has had her sense of smell return almost to normal and is now expanding the range of foods she can eat. All patients taking part in the research had an impaired sense of smell for longer than two years and other treatment, such as smell training or corticosteroids, had failed The operation, known as functional septorhinoplasty (fSRP), is typically used to correct any deviation of the nasal septum, increasing the size of nasal passageways. This, in turn, increases the airflow into the roof of the nasal cavity, which controls smell. Researchers believe increasing the delivery of odorants (chemical compounds that have a smell) to this area 'kick starts' smell recovery in patients who have lost that sense due to long Covid. Penelope Newman, 27, from south London, took part in the trial. Her results have been published in the journal Facial Plastic Surgery. She said: 'Before I had the surgery on my nose, I had begun to accept that I would probably never be able to smell or taste things the way I used to. It seemed dire, and after around two and a half years of parosmia [impaired sense of smell], I had totally changed my lifestyle. 'For those who have experienced this, they will know how isolating it can be. The food I could cook and eat was so limited, and I couldn't go out to restaurants as I would feel unwell. Getting something as drastic as surgery was a risk I was willing to take, on the small chance it might help. 'Since the surgery, I have begun to enjoy food and smells the same way I used to. I can now cook and eat garlic and onions, and people can cook for me, too. I can go out to eat with my friends and family. 'My taste and smell have almost returned to normal," she added. "I'm not sure if it will ever fully return as I still have a small reduction in it, but I am so glad that I am no longer as isolated as I once was.' The new research was led by Prof Peter Andrews, senior consultant surgeon in rhinology and facial plastic surgery, and Alfonso Luca Pendolino, then-senior rhinology fellow at UCLH. It included 25 long Covid patients, with 12 of the patients undergoing fSRP, while the control group of 13 patients continued with smell training – sniffing the same scents repeatedly – for the study. Sense of smell was measured over the duration of the study by using the Sniffin' Sticks test, a widely used clinical test to detect smell. All patients who had fSRP reported an improved sense of smell compared with none of the patients in the sniff test group, where 40 per cent actually reported the sense worsening. The experts said the surgery was particularly good at increasing odour sensitivity by lowering the odour threshold – the minimal concentration of an odour a person can actually smell – which is specifically noted in long Covid patients with the impaired sense. Prof Andrews said sense of smell 'is bit like a muscle ... the more you use it, the stronger it is. Just like a muscle.' The surgery increases the airway by about 30 per cent, so air flow also increases by about 30 per cent.
Sky News
07-03-2025
- Health
- Sky News
Surgery restores sense of smell in patients with long Covid
People who lost their sense of smell and accompanying taste because of long Covid have had it restored through nasal surgery. Experts used a technique for correcting blocked nasal passages on patients who have suffered a profound loss of smell after Covid infection. It's believed there could be up to 100,000 people in the UK who lost their sense of smell because of long Covid. Penelope Newman, 27, from south London, was one of those taking part in the new University College London Hospitals NHS Foundation Trust (UCLH) study. She said: "Before I had the surgery on my nose, I had begun to accept that I would probably never be able to smell or taste things the way I used to. "The food I could cook and eat was so limited, and I couldn't go out to restaurants as I would feel unwell. "Getting something as drastic as surgery was a risk I was willing to take on the small chance it might help." The operation, known as functional septorhinoplasty (fSRP), is typically used to correct any deviation of the nasal septum, increasing the size of nasal passageways and airflow to the region that controls smell. Researchers believe the surgery "kick starts" smell recovery in patients who have lost their sense of smell to long Covid. Ms Newman continued: "Since the surgery, I have begun to enjoy food and smells the same way I used to. "I can now cook and eat garlic and onions and people can cook for me too. I can go out to eat with my friends and family. "My taste and smell have almost returned to normal. I'm not sure if it will ever fully return as I still have a small reduction in it, but I am so glad that I am no longer as isolated as I once was. "I will never take my senses for granted ever again." The study included 25 long Covid patients, with 12 of the patients undergoing the surgery, while the control group of 13 patients continued with smell training - sniffing the same scents repeatedly - for the study. All patients who had the surgery reported an improved sense of smell compared with none of the patients in the sniff test group, where 40% actually reported a worsening sense of smell.
The Independent
07-03-2025
- Health
- The Independent
Patients have sense of smell restored thanks to surgery to treat long Covid
People who lost their sense of smell, and accompanying taste, because of long Covid, have had it restored thanks to nasal surgery. Experts at University College London Hospitals NHS Foundation Trust (UCLH) used a technique for correcting blocked nasal passages on patients who have suffered a profound loss of smell after Covid infection. Researchers believe between 50,000 and 100,000 people in the UK are suffering the effects of smell loss because of long Covid. One 27-year-old patient in the new UCLH study has had her sense of smell return almost to normal and is now expanding the range of foods she can eat. All patients taking part in the research had an impaired sense of smell for longer than two years and had failed on other treatments, such as smell training and corticosteroids. The operation, known as functional septorhinoplasty (fSRP), is typically used to correct any deviation of the nasal septum, increasing the size of nasal passageways. This increases the airflow into the olfactory region, at the roof of the nasal cavity, which controls smell. The team behind the new study said the surgery allows an increased amount of odorants (chemical compounds that have a smell) to reach the roof of the nose, where sense of smell is located. They believe increasing the delivery of odorants to this area 'kick starts' smell recovery in patients who have lost their sense of smell to long Covid. Penelope Newman, 27, from south London, took part in the trial. Her results have been published in the journal Facial Plastic Surgery. She said: 'Before I had the surgery on my nose, I had begun to accept that I would probably never be able to smell or taste things the way I used to. 'It seemed dire, and after around two and a half years of parosmia (impaired sense of smell), I had totally changed my lifestyle. 'For those who have experienced this, they will know how isolating it can be. 'The food I could cook and eat was so limited, and I couldn't go out to restaurants as I would feel unwell. 'Getting something as drastic as surgery was a risk I was willing to take on the small chance it might help. 'Since the surgery, I have begun to enjoy food and smells the same way I used to. 'I can now cook and eat garlic and onions and people can cook for me too. I can go out to eat with my friends and family. 'My taste and smell have almost returned to normal. I'm not sure if it will ever fully return as I still have a small reduction in it, but I am so glad that I am no longer as isolated as I once was. 'I will never take my senses for granted ever again.' The new research was led by Professor Peter Andrews, senior consultant surgeon in rhinology and facial plastic surgery, and Alfonso Luca Pendolino, then senior rhinology fellow at UCLH. It included 25 long Covid patients, with 12 of the patients undergoing fSRP, while the control group of 13 patients continued with smell training – sniffing the same scents repeatedly – for the study. Sense of smell was measured over the duration of the study by using the Sniffin' Sticks test, a widely-used clinical test to detect smell. All patients who had fSRP reported an improved sense of smell compared with none of the patients in the sniff test group, where 40% actually reported a worsening sense of smell. The experts said the surgery was particularly good at increasing odour sensitivity by lowering the odour threshold – the minimal concentration of an odour a person can actually smell – which is specifically noted in long Covid patients with an impaired sense of smell. Prof Andrews told the PA news agency that sense of smell 'is bit like a muscle', adding: 'The more you use it, the stronger it is. Just like a muscle.' He added: 'If you're breathing normally through your nose, you can just feel the air moving in the lower part of the nose, and you probably don't even notice it, but when you sniff, you can feel the air going up into the olfactory area, the roof of the nose. 'What this operation does is it increases that airway.' The surgery increases the airway by about 30%, so air flow also increases by about 30%. Prof Andrews added: 'There's a big group of patients who are still suffering with this problem of smell dysfunction following Covid infection three or four years ago. 'This study has shown impressive results – if we apply the principle of increasing the nasal or olfactory airway, we're getting a reactivation of the sense of smell and then an improvement of the sense of smell. 'With long Covid anosmia you've got patients, fundamentally, who can't smell or smell very poorly, so we need to somehow wake them up. 'And this operation sort of does that. It sort of wakes up the olfactory mucosa and then it builds on it through the increased nasal airway – hitting that area, more odorants hitting that area – and we're getting this impressive recovery in the majority of the patients. All patients we operated on improved.' Prof Andrews said persistent Covid anosmia is still a problem for an estimated 50,000 to 100,000 people. 'It's the sort of forgotten group of people, to be honest,' he said. 'If you lose your sense of smell it has incredible consequences. It's not until you've lost your sense of smell (that you realise) how it affects your taste, how it affects your daily living.' As a follow-up, researchers are now looking at the brain changes that happen following fSRP, which could explain its long-term benefits.
