Prostate cancer within a younger cohort of men, continues to be an increasing problem. With a younger population, greater expectations are present, from erectile function, to continence to oncological outcomes. Significant prostate cancer is increasingly diagnosed in younger men, less than 55 years. In a non-screened population young patients are choosing radical surgery for intermediate and high risk disease . This patient group have high expectations with regards to oncological and functional outcomes. The next question arises, what can we do to improve outcomes?