Patient Reported Outcomes of Urinary Incontinence Rates Using Viable Cryopreserved Umbilical Tissue Over Neurovascular Bundles During Robotic Assisted Radical Prostatecomy
Journal of Urology
INTRODUCTION AND OBJECTIVE:
Incontinence remains a side effect from robotic assisted radical prostatectomy (RARP) for prostate cancer despite nerve sparing (NS) and bladder neck reconstruction techniques. Use of growth factors and anti-inflammatory substances over neurovascular bundles is an emerging technique to enhance recovery of continence and potency. Viable cryopreserved umbilical tissue (vCUT) is FDA approved for homologous use in surgery. The objective is to determine if vCUT use in NS-RARP accelerates return to continence.
Retrospective review of 176 patients who underwent NS-RARPs from October 2015 through July 2020 were identified through the Michigan Urological Surgery Improvement Collaborative (MUSIC). Return to social urinary continence (0-1 pads per day) at 3 months postoperatively was evaluated using MUSIC patient-reported outcome (PRO), a validated questionnaire to assess urinary and sexual issues at baseline and after treatment. Multivariable logistic regression model was used to assess association between the use of vCUT as social continence.
We identified 113 vCUT patients and 64 non-vCUT patients who underwent NS-RARP during our time frame. Based on MUSIC-PRO data, continence was achieved by 3 months post-op in 87% (98/113) of v-CUT patients versus only 72% (46/64) in non-vCUT patients (p=0.015). On multivariable analysis (controlling for age, BMI, diabetes, and baseline continence), although not reaching conventional statistical significance, vCUT patients were more likely to achieve continence than non-vCUT patients (OR=2.30, p=0.061) (table 1).
Use of vCUT during NS-RAP may promote quicker return to social urinary continence. Further larger studies with longer follow up are required to further evaluate effectiveness of vCUT to enhance return of continence and potency.
Shah M, Geisenhoff A, Kraemer S, Qi J, Dave C, Sun F, et al. [Shetty S, Seifman B, Hafron J]. Patient reported outcomes of urinary incontinence rates using viable cryopreserved umbilical tissue over neurovascular bundles during robotic assisted radical prostatectomy. J Urol. 2022 May;207(Suppl 5):e1027. doi:10.1097/JU.0000000000002645.06.
American Urological Association Annual Meeting, May 13-16, 2022, New Orleans, LA.