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. 2021 Dec;15(6):877-883.
doi: 10.1007/s11701-020-01187-z. Epub 2021 Jan 11.

Cryopreserved placental tissue allograft accelerates time to continence following robot-assisted radical prostatectomy

Peter A Elliott  1 , Stephanie Hsiang  2 , Ramkishen Narayanan  2 , James Bierylo  2 , Shu-Ching Chang  3 , Przemyslaw Twardowski  2 , Timothy G Wilson  2
Affiliations

Cryopreserved placental tissue allograft accelerates time to continence following robot-assisted radical prostatectomy

Peter A Elliott et al. J Robot Surg. 2021 Dec.

Abstract

Intra-operatively placed cryopreserved placental tissue allograft (CPTA) has shown promise in expediting the recovery urinary continence (UC) following robot-assisted radical prostatectomy (RARP). In this retrospective review of a prospectively maintained single-surgeon, single-institution RARP database, we compare three groups of patients: historical controls (C; N = 183 men) that received no allograft versus two different CPTA products (total CPTA N = 162 [A1 N = 81; A2 N = 81]). The CPTA product was intra-operatively placed as an onlay over the area of the neurovascular bundles during RARP. CPTA cases had significantly faster median time to UC (A1 = 1.4 months; A2 = 1.45 months) versus controls (1.64 months), p = 0.01. On multivariable analysis, use of A1 (HR 1.55, 95% CI [1.14-2.09], p = 0.005) and use of A2 (HR 1.53, CI [1.11-2.11], p = 0.01) were significantly associated with quicker return of UC. Older age (HR 0.97, CI [0.96-0.99], p = 0.001) and non-organ-confined clinical stage (HR 0.51, CI [0.26-1.0] p = 0.05), were significantly associated with slower return of UC. In a propensity score-matched analysis of 77 CPTA patients with sufficient follow-up versus controls, there was significantly less biochemical recurrence (BCR; p = 0.01). Our study indicates that CPTA use appears to accelerate time to UC in age- and performance status-matched men undergoing RARP without increased risk of BCR.

Keywords: Biochemical recurrence; Cryopreserved placental tissue allograft; Incontinence; Prostate cancer.

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References

    1. Ficarra V, Novara G, Rosen RC, Artibani W, Carroll PR, Costello A, Menon M, Montorsi F, Patel VR, Stolzenburg JU, Van der Poel H, Wilson TG, Zattoni F, Mottrie A (2012) Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol 62(3):405–417. https://doi.org/10.1016/j.eururo.2012.05.045 - DOI - PubMed
    1. Ilic D, Evans SM, Allan CA, Jung JH, Murphy D, Frydenberg M (2017) Laparoscopic and robotic-assisted versus open radical prostatectomy for the treatment of localised prostate cancer. Cochrane Database Syst Rev 9:CD009625. https://doi.org/10.1002/14651858.CD009625.pub2 - DOI - PubMed
    1. Alemozaffar M, Sanda M, Yecies D, Mucci LA, Stampfer MJ, Kenfield SA (2015) Benchmarks for operative outcomes of robotic and open radical prostatectomy: results from the Health Professionals Follow-up Study. Eur Urol 67(3):432–438. https://doi.org/10.1016/j.eururo.2014.01.039 - DOI - PubMed
    1. Vis AN, van der Poel HG, Ruiter AEC, Hu JC, Tewari AK, Rocco B, Patel VR, Razdan S, Nieuwenhuijzen JA (2019) Posterior, Anterior, and Periurethral surgical reconstruction of urinary continence mechanisms in robot-assisted radical prostatectomy: a description and video compilation of commonly performed surgical techniques. Eur Urol 76(6):814–822. https://doi.org/10.1016/j.eururo.2018.11.035 - DOI - PubMed
    1. Thompson JE, Egger S, Bohm M, Siriwardana AR, Haynes AM, Matthews J, Scheltema MJ, Stricker PD (2018) Superior biochemical recurrence and long-term quality-of-life outcomes are achievable with robotic radical prostatectomy after a long learning curve-updated analysis of a prospective single-surgeon Cohort of 2206 consecutive cases. Eur Urol 73(5):664–671. https://doi.org/10.1016/j.eururo.2017.11.035 - DOI - PubMed

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