BOSTON -- The most aggressive treatment for prostate cancer is surgery. Nerve-sparing prostate surgery can help prevent side effects, but in some cases, the placement and size of the cancer make sparing those nerves impossible.

But a new type of nerve transplant may help men retain sexual function after prostate surgery.

Teacher Norm DeMarais, 60, chose surgery when he learned he had prostate cancer, despite the side effects.

"My major thing was to get rid of the cancer," DeMarais said. "There are side effects, certainly."

In 10 percent of cases, including DeMarais', the cancer is positioned too close to the nerves surrounding the prostate that control sexual function, and those nerves must be removed.

A new type of surgery -- sural nerve transplant -- is giving these patients hope. Surgeons first remove the cancerous prostate and surrounding nerves. They then go to the ankle and take a 3- to 4-inch piece of the sural nerve that runs up the side of the calf and transplant it into the prostate area.

While this type of transplant is now being done at a few top hospitals around the country, Dr. Ingolf Tuerk, of the Lahey Clinic in Massachusetts, has developed a new twist. Instead of one large incision to remove the prostate and transplant the nerve, he does it laproscopically, using a series of small incisions and a tiny camera that magnifies the area 16 times its normal size.

"Since you're avoiding this big incision, the morbidity of patients is smaller," Tuerk said. "There's faster recovery, magnification for the surgeon and less blood loss for the patient."

While there is no research yet on the effectiveness of the laproscopic form of the surgery, studies show those who had the traditional nerve transplant technique were at least 30 percent more likely to regain their erections than those who did not.

This is particularly important, urologists say, because simple prostate cancer screening methods, such as the PSA test, are catching cancer sooner.

"We're picking up prostate cancer in younger, healthier men who have good, normal erectile function, and I'd like to somehow preserve that," Dr. Karim Hamawy said.

DeMarais had the surgery in January, and it successfully removed the cancer. It will take at least 18 months before it's known if the nerve transplant worked. He said he had little to lose.

"I was very in favor of it and thought, let's try it, and if it works, wonderful, and if it doesn't, well than at least we tried it," he said. "And the cancer's gone."

Even without the nerves, medications like Viagra can help.

Experts said that while there was no research on the laproscopic form of surgery, there is very little risk. The Lahey Clinic has launched a study on the technique.