Nerve-sparing prostatectomy shows promise in dogs with early tumors
Bottom line
Version 1
A newly published retrospective case series suggests that nerve-sparing total prostatectomy may be more feasible in carefully selected dogs with early-stage prostatic tumors than many clinicians have assumed. In 22 dogs with T1 to T3 prostatic tumors or preneoplastic lesions, the procedure was associated with a low rate of surgical complications, 68.2% long-term full urinary continence, and improved survival, with or without adjuvant chemotherapy, according to the study by Salmina, Chiti, Cinti, and Massari. The report adds to a small but growing body of literature indicating that earlier surgical intervention, before extensive local invasion, may improve outcomes in canine prostatic cancer. (pubmed.ncbi.nlm.nih.gov)
Why it matters: For veterinary professionals, the finding is notable because total prostatectomy in dogs has long been approached cautiously due to historically high rates of postoperative incontinence and the aggressive biology of prostatic carcinoma. Reference sources still note that total prostatectomy is generally not recommended because many dogs already have metastasis at diagnosis and continence outcomes have been poor. This new series suggests that a nerve-sparing approach, used in earlier-stage disease, could shift that discussion for selected referral cases, especially where staging shows T1 to T3 disease without the degree of invasion typically associated with worse outcomes. (merckvetmanual.com)
What to watch: The next question is whether larger, prospective studies can confirm which dogs benefit most, and whether nerve-sparing surgery plus adjuvant therapy can reliably outperform medical management across institutions. (bmcvetres.biomedcentral.com)
Version 2
A new case series is putting fresh attention on surgery for canine prostatic tumors, an area where prognosis has traditionally been guarded and treatment has often focused on palliation. In 22 dogs with T1 to T3 prostatic tumors, nerve-sparing total prostatectomy, with or without adjuvant chemotherapy, was linked to a low rate of surgical complications, durable urinary continence in many patients, and improved survival. The paper was indexed on PubMed in March 2026 and adds new clinical data to a field where evidence remains limited. (pubmed.ncbi.nlm.nih.gov)
That matters because the conventional view of canine prostatic carcinoma has been shaped by late diagnosis, frequent metastasis, and poor tolerance of radical surgery. Merck Veterinary Manual notes that gross metastases are present at diagnosis in more than 80% of dogs with prostatic carcinoma and states that total prostatectomy is generally not recommended because of the high incidence of postoperative urinary incontinence. Review literature published in 2024 and 2025 similarly describes prognosis as guarded, while emphasizing that surgery has not consistently shown clear oncologic benefit across the broader population of dogs with prostatic carcinoma. (merckvetmanual.com)
The newer data fit with a trend already emerging from earlier retrospective work: outcomes appear better when surgery is used in selected dogs with less advanced disease. A 2022 BMC Veterinary Research study of 41 dogs with prostatic adenocarcinoma found significantly longer median survival with surgical treatment than with medical management alone, and within the surgical cohort, dogs undergoing total prostatectomy had substantially longer postoperative median survival than those requiring more extensive prostatocystectomy. That study concluded that early detection was key to a survival advantage with surgery, especially when the tumor had not infiltrated the bladder. (bmcvetres.biomedcentral.com)
Against that backdrop, the new nerve-sparing series is important because it focuses specifically on T1 to T3 tumors and emphasizes functional outcomes, not just survival. According to the study abstract, 68.2% of dogs achieved full urinary continence long term, a figure that stands out in a disease area where incontinence has often been the limiting factor in surgical decision-making. The study also reports a low surgical complication rate and improved survival, with some dogs receiving adjuvant chemotherapy. While the full paper would be needed to assess selection criteria, margin status, tumor subtypes, chemotherapy protocols, and follow-up in detail, the topline message is that preserving periprostatic neurovascular structures may improve quality-of-life outcomes in appropriately staged patients. (pubmed.ncbi.nlm.nih.gov)
There doesn't appear to be a standalone press release or broad industry reaction available yet, but the broader expert literature helps frame the result. Recent reviews describe veterinary prostate cancer treatment as an area in flux, with interest in multimodal care, interventional oncology, and more refined surgical approaches. A 2025 review of minimally invasive oncology procedures noted that nerve-sparing and robotic prostatectomy techniques have been explored in dogs, but also stressed that case selection remains poorly defined and that stronger outcome data are still needed. In other words, the field has been waiting for exactly this kind of more focused surgical outcomes report. (veterinaryoncology.biomedcentral.com)
Why it matters: For veterinarians, this study may be most useful as a case-selection signal rather than a practice-changing mandate. It suggests that in referral settings, dogs with earlier-stage prostatic tumors could be candidates for a more aggressive local approach if staging supports resectability and if pet parents are counseled carefully about risks, continence expectations, metastatic potential, and the possible role of chemotherapy. It also reinforces the value of earlier workup in male dogs with dysuria, tenesmus, stranguria, or suspicious prostatic imaging, because the window for meaningful surgical benefit may close once bladder invasion or advanced metastatic disease is present. (bmcvetres.biomedcentral.com)
The study should still be interpreted with caution. It is a retrospective series with 22 dogs, and retrospective oncology data are vulnerable to referral bias, stage migration, inconsistent adjunctive treatment, and uneven follow-up. Even so, if nerve-sparing techniques can reproducibly lower incontinence rates while extending survival in T1 to T3 disease, they could reopen the conversation around prostatectomy in dogs, at least for a narrow subset of patients that historically may have been steered toward palliation alone. (pubmed.ncbi.nlm.nih.gov)
What to watch: Watch for the full article's wider uptake in oncology and surgery circles, plus any prospective or multi-institutional follow-up studies that clarify staging criteria, chemotherapy benefit, and whether these continence outcomes hold up outside experienced centers. (pubmed.ncbi.nlm.nih.gov)