No metastases but neurovascular involvement.

Not really noticed this before. Here are some information from AI about the risks.

Neurovascular involvement is heavily related to prostate cancer, serving as a key pathway for tumor spread, an indicator of disease progression, and a critical factor in treatment planning. The prostate is a nerve-rich organ, and cancer cells often use these nerve fibers to migrate outside the prostate gland (perineural invasion or PNI).

2. Neurovascular Bundle (NVB) in Treatment
Radical Prostatectomy: Surgeons often need to decide whether to spare or resect (remove) the neurovascular bundles, which are responsible for erectile function and urinary continence.
Risk vs. Function: While preserving the bundles helps with post-operative potency, they are also the most common route for cancer to escape the prostate. However, recent studies suggest that in selected high-risk cases, nerve-sparing surgery may be safe and not compromise long-term oncological outcomes.
Radiotherapy: Radiation damage to the neurovascular bundles is a known cause of erectile dysfunction after treatment.

Neurovascular involvement or PNI (perineural invasion) do sound ominous.
But recent studies indicate that it is more a measurement of disease volume, rather than aggressiveness; there are a lot of cancer cells spreading toward the sides of the gland.
Of course, in extreme cases this spread could cause ExtraCapsular Extension (EPE) - a bulge; even worse is an actual break in the capsule.
Long story short, better NOT to have it, but having it does NOT mean a worse outcome. Best,
Phil

Thank you. That’s encouraging.