Presentation Authors: Francesco Porpiglia, Matteo Manfredi, Enrico Checcucci, Diletta Garrou, Sabrina De Cillis, Gabriele Volpi, Giovanni Cattaneo, Federico Piramide, Alberto Piana, Daniele Amparore, Francesca Ragni, Cristian Fiori*, Orbassano, Italy
Introduction: To evaluate the potency recovery after 1 year follow up in patients undergonechitosan membrane (ChiMe) application on neuro-vascular bundles (NVB) during nerve-sparing (NS) robot-assisted radical prostatectomy (RARP). To compare the results with those of a contemporary cohort of patients who had not benefited from chitosan use.
Methods: We enrolled patients undergone NS-RARP with ChiMe applied on the NVB from July 2015 to September 2016 in a preliminary phase II study. They were followed to complete one-year follow-up. The control group was composed of patients who underwent NS-RARP without the application of ChiMe in the same period of time. The patients were stratified into two groups on the basis of the amount of nerves spared: group A, patients who benefited from a monolateral or a bilateral full NS; group B, patients in which a full NS was not performed. The demographics, perioperative, and postoperative data, and complications, were collected. Potency recovery rate was recorded in both groups.
Results: 136 patients were enrolled in the ChiMe group, with 334 patients in the control group. Both groups were comparable in terms of baseline variables. On the basis of nerve sparing, 183 patients were included in group A, with 287 in group B. Odds ratios at different time points showed that the only two factors influencing the potency recovery were the amount of nerves preserved (group A v. group B) and the application or not of ChiMe on the NVBs spared. A statistically significant improvement of the potency recovery rate in the ChiMe group v. Control group was found at one (36.76% vs 25.88%; p=0.02) and two (52.2% vs 39.22%; p=0.01) months after surgery, moreover we recorded a favorable trend at every time point of the whole follow-up period, even if not significant after the second postoperative month. As concerns group A, the Log-Rank test showed a statistically significant difference between ChiMe v. control group (p=0.02), in particular at one and two months after surgery (p=0.02 and p=0.01, respectively).
Conclusions: The application of ChiMe on the NVBs resulted in a higher potency recovery rate at one and two months after a bilateral or monolateral full NS RARP. A trend towards a faster recovery of erectile function in the ChiMe groups was recorded at every time point, even in the cohort of patients who underwent a non-full NS procedure.