Title

Dehydrated Human Amnion/Chorion Membrane Allograft Nerve Wrap Around the Prostatic Neurovascular Bundle Accelerates Early Return to Continence and Potency Following Robot-assisted Radical Prostatectomy: Propensity Score-matched Analysis

Authors

Authors

V. R. Patel; S. Samavedi; A. S. Bates; A. Kumar; R. Coelho; B. Rocco;K. Palmer

Comments

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Abbreviated Journal Title

Eur. Urol.

Keywords

Biological dressings; Prostatic neoplasms; Robotics; Erectile; dysfunction; Urinary incontinence; Convalescence; Urology & Nephrology

Abstract

We present a propensity-matched analysis of patients undergoing placement of dehydrated human amnion/chorion membrane (dHACM) around the neurovascular bundle (NVB) during nerve-sparing (NS) robot-assisted laparoscopic prostatectomy(RARP). From March 2013 to July 2014, 58 patients who were preoperatively potent (Sexual Health Inventory for Men [SHIM] score > 19) and continent (no pads) underwent full NS RARP. Postoperative outcomes were analyzed between propensity-matched graft and no-graft groups, including time to return to continence, potency, and biochemical recurrence. dHACM use was not associated with increased operative time or blood loss or negative oncologic outcomes (p > 0.500). Continence at 8 wk returned in 81.0% of the dHACM group and 74.1% of the no-dHACM group (p = 0.373). Mean time to continence was enhanced in group 1 patients (1.21 mo) versus (1.83 mo; p = 0.033). Potency at 8 wk returned in 65.5% of the dHACM patients and 51.7% of the no-dHACM group (p = 0.132). Mean time to potency was enhanced in group 1, (1.34 mo), compared to group 2 (3.39 mo; p = 0.007). Graft placement enhanced meantime to continence and potency. Postoperative SHIM scores were higher in the dHACM group at maximal follow-up (mean score 16.2 vs 9.1). dHACM allograft use appears to hasten the early return of continence and potency in patients following RARP. (C) 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Journal Title

European Urology

Volume

67

Issue/Number

6

Publication Date

1-1-2015

Document Type

Article

Language

English

First Page

977

Last Page

980

WOS Identifier

WOS:000353808900006

ISSN

0302-2838

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