MP15-04 THE EFFECT OF MICROPOROUS POLYSACCHARIDE HEMOSPHERES ON PATIENT OUTCOMES FOLLOWING ROBOT-ASSISTED RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy I (MP15)1 Sep 2021MP15-04 THE EFFECT OF MICROPOROUS POLYSACCHARIDE HEMOSPHERES ON PATIENT OUTCOMES FOLLOWING ROBOT-ASSISTED RADICAL PROSTATECTOMY Wissam Abou Chedid, Sarosh Janardanan, Liam Kavanagh, and Christopher Eden Wissam Abou ChedidWissam Abou Chedid More articles by this author , Sarosh JanardananSarosh Janardanan More articles by this author , Liam KavanaghLiam Kavanagh More articles by this author , and Christopher EdenChristopher Eden More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001996.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Controlling bleeding without disturbing the anatomy and function of the structures in the prostate bed remains a significant challenge during radical prostatectomy (RP). METHODS: The outcomes of 862 patients having robot-assisted RP (RARP) during a 5-year period were analyzed from a prospective database. The last 422 patients in the series had 5 g powdered microporous polysaccharide hemospheres (MPH) (Arista (TM), Becton Dickinson, USA) applied to the prostate bed at the end of surgery and the first 440 patients (control group) did not. Continence was defined as no pads and potency as the ability to have penetrative sex with or without PDE5 inhibitors in previously potent, non-diabetic men aged <70 years following bilateral intra- or inter-fascial neurovascular bundle (NVB) preservation. RESULTS: The control group contained higher-risk patients who had less nerve sparing done with a greater use of the Retzius-sparing approach (p=<0.01) but the two groups otherwise had similar demographic characteristics. Patients who received MPH had a trend towards a lower post-op. transfusion rate (p=0.12) and fewer total complications from post-operative bleeding (p=0.07) but these differences did not reach statistical significance. However, they had a significantly shorter operating time (p=<0.01), lower intra-operative blood loss, (p=<0.01), shorter hospital stay (p=<0.01), better continence and potency (p=<0.01) at 4 weeks, and better potency (p<0.01), trifecta (p=<0.01) and pentafecta (p=<0.01) rates at 1 year. CONCLUSIONS: The mechanism of the superior potency observed in the MPH group is unclear and may be due to less damage to the NVB following its preservation by clips and sutures, less local inflammation due to coating of the NVBs by a gel matrix, greater surgical experience or most likely a combination of these factors. The better early continence observed in the MPH group may be a consequence of better NVB preservation and its recognized beneficial effect on external urinary sphincter function. These results await further investigation within a randomized controlled trial . Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e264-e265 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Wissam Abou Chedid More articles by this author Sarosh Janardanan More articles by this author Liam Kavanagh More articles by this author Christopher Eden More articles by this author Expand All Advertisement Loading ...