MP84-03 INTERPOSITION OF NOVEL NERVE-REGENERATION CONDUIT AFTER WIDE EXCISION OF THE NEUROVASCULAR BUNDLE DURING RADICAL PROSTATECTOMY DID NOT IMPROVE POSTOPERATIVE ERECTILE FUNCTION

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Penis/Testis/Urethra: Benign Disease & Malignant Disease II1 Apr 2018MP84-03 INTERPOSITION OF NOVEL NERVE-REGENERATION CONDUIT AFTER WIDE EXCISION OF THE NEUROVASCULAR BUNDLE DURING RADICAL PROSTATECTOMY DID NOT IMPROVE POSTOPERATIVE ERECTILE FUNCTION Nobuyuki Hinata, Junya Furukawa, Ken-ichi Harada, Yuzo Nakano, and Masato Fujisawa Nobuyuki HinataNobuyuki Hinata More articles by this author , Junya FurukawaJunya Furukawa More articles by this author , Ken-ichi HaradaKen-ichi Harada More articles by this author , Yuzo NakanoYuzo Nakano More articles by this author , and Masato FujisawaMasato Fujisawa More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2771AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In select cases of high-volume prostate cancer, a wide excision of the neurovascular bundle is the treatment option. However, this technique could cause postoperative erectile dysfunction. Treatment using nerve-regeneration conduit (NRC) has been shown to be equally or more effective than the nerve autograft and nerve suture for patients with somatic nerve injuries. We investigated efficacy of NRC interposition on return of erectile function after wide excision during radical prostatectomy. METHODS After institutional review board approval, a total of 78 patients (42 unilateral, 36 bilateral) underwent unilateral or bilateral wide excision during robot-assisted radical prostatectomy between December 2013 and September 2016. They were classified into 2 groups, that is unilateral nerve preservation with contralateral NRC (polyglycolic acid collagen tube; NerbridgeTM) interposition and bilateral wide excision with bilateral NRC interposition. Postoperative data of these patients were compared with the data obtained from 136 patients who underwent wide excision during RARP between October 2010 to November 2013. Potency was estimated by the SHIM score and erection hardness score (EHS). The data from the patients with preoperative SHIM score > 17 were used for the analyses. RESULTS No complication related to the interposition of the NRC was observed. Recovery rates of the SHIM score to the baseline at 12 months postoperatively for unilateral and bilateral groups were 15.8% and 0%, respectively. The recovery of EHS scores to the baseline were not observed at 12 months postoperatively in both groups. The recovery rate of EHS score with NRC interposition group was not significantly higher than the rate without NRC interposition group for both of the unilateral and bilateral groups. CONCLUSIONS NRC interposition did not improve postoperative erectile function in patients who received wide excision during RARP. Scaffold for peripheral autonomic nerve regeneration seemed not to work because mesh-like cavernous nerves could not be replaced by a linear nerve. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1125 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Nobuyuki Hinata More articles by this author Junya Furukawa More articles by this author Ken-ichi Harada More articles by this author Yuzo Nakano More articles by this author Masato Fujisawa More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...