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

    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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