MP54-07 CRYOPRESERVED PLACENTAL TISSUE ALLOGRAFT ACCELERATES TIME TO CONTINENCE AFTER ROBOTIC RADICAL PROSTATECTOMY

Abstract

INTRODUCTION AND OBJECTIVES: Urinary continence (UC) after robotic radical prostatectomy (RARP) represents, arguably, the higher priority post‐operative quality of life outcome for most men. Data on early recovery of UC post‐RARP are as heterogeneous as techniques striving to attain early UC. Cryopreserved placental tissue allograft (CPTA) is established in local wound care to promote repair/ healing. We report our UC outcomes from use of intraoperative CPTA during RARP. METHODS: Retrospective review of a prospectively maintained single‐surgeon, single‐institution RARP database. We defined urinary continence (UC) as ≤1 pad used in a 24 hour period. We compared 3 groups of patients: historical control (no allograft) and 2 different CPTA products (P1 and P2). CPTA product was placed as an on‐lay over the area of the neurovascular bundles immediately prior to urethrovesical anastomosis. Fisher exact test was used for categorical variables; ANOVA analysis or Kruskal‐Wallis rank sum test was used for continuous variables. RESULTS: Control (C) N=182 men; CPTA N=119 (P1 N=60; P2 N=59). Median age was similar across all groups [C= 66 years old (60‐71); P1 = 66 yo (59‐69); P2 = 68 yo (61.5‐71.5)], p=0.16. Post‐ RARP, CPTA cases had significantly faster median time to UC (P1 = 1.4 months; P2 = 1.3 mo) versus controls (1.6 mo), p=0.01. P1 cases had higher UC vs controls at 3 mo (78.3% vs 60.4%, p=0.01) and 4 mo (78.3% vs 63.7%, p=0.04) post‐op. P2 cases showed a trend toward improved UC vs controls at 3 mo (74.6% vs 60.4%, p=0.06) and significantly improved UC at 4 mo (81.4% vs 63.7%, p=0.02). From multivariable logistic regression analysis, odds of being continent at 3 mo was significantly higher for both P1 OR=2.23 [95% CI = (1.12, 4.45), p=0.02] and P2 OR=2.07 [95% CI = (1.06, 4.03), p=0.03] compared to controls; this significant association was also observed at 4 mo for P2 (OR=2.62, p=0.01), but not P1. Beyond 4 mo, neither CPTA product showed improved time to UC vs controls. CONCLUSIONS: CPTA use appears to accelerate time to UC in age‐ and performance status‐matched men undergoing RARP. We believe that our current findings justify a randomized controlled trial to more accurately gauge whether CPTA should become incorporated into RARP to improve postoperative functional outcomes. (Figure Presented).