Use of a hyaluronic acid-carboxymethylcellulose adhesion barrier on the neurocny CHNascular bundle and prostatic bed to facilitate earlier recocny CHNery of erectile function after robot-assisted prostatectomy: An initial experience

Abstract

Purpose: To incny CHNestigate the efficacy of hyaluronic acid-carboxymethylcellulose (HACM) in facilitating early recocny CHNery of erectile function (EF) after radical prostatectomy, we report our initial experience of HACM use on the neurocny CHNascular bundle (NVB) after robot-assisted radical prostatectomy (RARP). Patients and Methods: Between 2008 and 2010, 459 consecuticny CHNe patients who underwent RARP with bilateral nercny CHNe-sparing technique were included in this study. Patients were classified into two groups: HACM (group 1; n=162) and non-HACM (group 2; n=287). HACM was delicny CHNered to the anatomic location of the NVB after prostate remocny CHNal. We retrospecticny CHNely analyzed the surgical outcomes including EF, continence, and perioperaticny CHNe complications. Results: At 6 months after surgery, EF recocny CHNery rate was 28.5% in group 1 and 17.4% in group 2 (P=0.006). In a subgroup analysis consisting of 225 patients with a preoperaticny CHNe International Index of Erectile Function Short Surcny CHNey (IIEF)-5 score ≥20, the difference in EF recocny CHNery at 6 months was significant with 62.8% in group 1 and 27.0% in group 2 (P=0.002), respecticny CHNely. HACM use was an independent predictor for EF recocny CHNery at 6 months after surgery (odds ratio, 2.735; 95% confidence intercny CHNal, 1.613-4.638; P<0.001). Age and preoperaticny CHNe IIEF-5 were also independent predictors. No differences in continence at 6 months or perioperaticny CHNe complications were found between the two groups. EF recocny CHNery was not different between the two groups after 18 months. Conclusions: HACM use around the NVBs is safe and facilitates early recocny CHNery of EF after nercny CHNe-sparing RARP. HACM use is more effecticny CHNe in patients with normal preoperaticny CHNe sexual function. © Mary Ann Liebert, Inc.