Login to Access Video or Poster Abstract: MP93-18
Sources of Funding: none

Introduction

To explore the technical feasibility of using processed nerve allograft in cavernous nerve repair during robot-assisted radical prostatectomy (RARP).

Methods

Twelve prostate cancer patients with normal pre-operative erectile and urinary function were enrolled in an IRB approved single arm pilot study to receive RARP with unilateral cavernous nerve reconstruction using processed nerve allograft. Patients were followed for 24 months after surgery. Erectile and urinary functional recovery was measured using the International Index of Erectile Function-EF domain (IIEF-6) and the Expanded Prostate cancer Index Composite (EPIC, Version 2.2002) questionnaires. Possible adverse events related to nerve graft implantation were assessed.

Results

Planned surgery was successfully performed in all 12 patients by a single surgeon without any attributed complications or adverse events. The implantation procedure extended operation time by16 ± 4.3 minutes. Two patients received androgen deprivation therapy post-operatively and were excluded from analysis. Partial recovery of erectile function (IIEF ≥13) was seen in 50% and 70% of patients by 12 and 24 months after surgery respectively, while recovery of potency (erection firm enough for intercourse, IIEF ≥22) was achieved in 50% of patients 24 months after surgery. Urinary continence (0-1 pad used per day) was restored in 75%, 83.3% and 91.7% of patients by 6, 12 and 24 months after surgery, respectively.

Conclusions

Cavernous nerve reconstruction using processed nerve allograft during robot-assisted radical prostatectomy is technically feasible and shows promise in recovery of desirable functional outcomes.

Funding

none