Functional and Oncologic Outcomes Following Perinatal Tissue Allograft Placement During Nerve-Sparing...

Area of Science:

• Urology
• Surgical Innovation
• Regenerative Medicine

Background:

• Delayed recovery of erectile function and urinary continence is common after robotic-assisted radical prostatectomy (RARP), despite nerve-sparing techniques.
• Perinatal tissue allografts are emerging as a potential solution for protecting cavernous nerves during RARP.

Purpose of the Study:

• To evaluate the feasibility and safety of using perinatal tissue allografts as a covering for cavernous nerves during nerve-sparing RARP.
• To assess the impact of allograft placement on the recovery of erectile function and urinary continence.

Main Methods:

• A case series of 14 patients undergoing nerve-sparing RARP with perinatal allograft placement between 2022 and 2024.
• Allografts were circumferentially positioned around cavernous nerve bundles, aiming for >90% coverage.
• Postoperative outcomes included erectile function (SHIM score ≥17) and continence (≤1 pad/day), with follow-up at 3, 6, and 9 months.

Main Results:

• At 9 months, 91.7% of patients had erections, with 57.1% achieving potency within a median of 90 days.
• At 9 months, 75.0% of patients achieved continence, with a median time to continence of 90 days.
• No patients experienced biochemical recurrence during follow-up.

Conclusions:

• Perinatal tissue allograft placement is a feasible method for covering and protecting cavernous nerves during RARP.
• This technique appears to accelerate the return of potency and continence following nerve-sparing RARP.
• Further research is warranted to compare outcomes with traditional nerve-sparing RARP.