Chitosan membranes applied on the prostatic neurovascular bundles after nerve‐sparing robot‐assisted radical prostatectomy: a phase <scp>II</scp> study

Porpiglia, Francesco; Bertolo, Riccardo; Fiori, Cristian; Manfredi, Matteo; Cillis, Sabrina De; Geuna, Stefano

doi:10.1111/bju.13959

Cited by 19 publications

(21 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In that preliminary phase II study, we showed the feasibility and safety of applying ChiMe on the NVBs. Moreover, we found a trend towards faster recovery of erectile function relative to our previous experiments [6].…”

Section: Introductionsupporting

confidence: 54%

See 1 more Smart Citation

Use of chitosan membranes after nerve‐sparing radical prostatectomy improves early recovery of sexual potency: results of a comparative study

et al. 2018

Self Cite

View full text Add to dashboard Cite

Objectives To evaluate the 1‐year efficacy of chitosan membrane (ChiMe) application on the neurovascular bundles (NVBs) after nerve‐sparing (NS) robot‐assisted radical prostatectomy (RARP) in potency recovery rate. To compare the results with those of a contemporary cohort of patients who did not benefit from chitosan use. Patients and Methods Patients in the ChiMe group were enrolled at our institution from July 2015 to September 2016 in a preliminary phase II study. All of them underwent NS‐RARP with ChiMe applied on the NVBs and were followed over time to complete a 1‐year follow‐up. The control group was composed of patients who underwent NS‐RARP at our institution without the application of ChiMe from January 2015. The patients were further classified into two groups based on the amount of nerves spared: Group A, comprised patients who underwent a monolateral or bilateral full NS; Group B, comprised patients in which a full NS was not performed. The demographics, peri‐ and postoperative data, and complications were recorded and compared. Potency recovery was recorded for Group A vs Group B in both the ChiMe and the control groups. Results In all, 136 patients were enrolled in the ChiMe group and 334 patients in the control group. There were no differences between groups in terms of baseline variables. Based on the amount of nerves preserved, 183 patients were included in Group A and 287 in Group B. Odds ratios at different time points showed that the only two factors influencing potency recovery were the amount of nerves preserved (Group A vs Group B) and the application or not of ChiMe on the NVBs spared. Comparing the ChiMe vs control groups at different time points, we found a statistically significant improvement in the potency recovery rate in the ChiMe group at 1 month (36.76% vs 25.88%; P = 0.02) and 2 months (52.2% vs 39.22%; P = 0.01) after surgery, showing a favourable trend at every time point of the entire follow‐up period, even if not significant after the second postoperative month. In Group A, the log‐rank test showed a statistically significant difference between the ChiMe vs control groups (P = 0.02), in particular at 1 and 2 months after surgery (P = 0.02 and P = 0.01, respectively). Conclusion The application of ChiMe on the NVBs resulted in a higher potency recovery rate at 1 and 2 months after a bilateral or monolateral full NS‐RARP. A trend of a higher and shorter potency recovery rate showed it to be favourable to use ChiMe, even in the cohort of patients who did not undergo a full NS procedure.

show abstract

Section: Introductionsupporting

confidence: 54%

“…In order to contribute to this field, our group published a feasibility phase II study in which ChiMes were applied at the level of NVBs at the end of NS‐RARP in 140 patients , confirming the feasibility and safety of the technique.…”

Section: Discussionmentioning

confidence: 96%

Use of chitosan membranes after nerve‐sparing radical prostatectomy improves early recovery of sexual potency: results of a comparative study

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…In the near future, the association of such a technology together with the use of new regenerative materials on the preserved NVBs will promote the morphological and functional regeneration of the neurovascular network . Indeed, if the neuronal damage can be limited to a small area, the need of nervous regeneration will be small.…”

Section: Discussionmentioning

confidence: 99%

Augmented‐reality robot‐assisted radical prostatectomy using hyper‐accuracy three‐dimensional reconstruction (HA3D™) technology: a radiological and pathological study

et al. 2018

Self Cite

View full text Add to dashboard Cite

ObjectivesTo assess the use of hyper-accuracy three-dimensional (HA3D TM ; MEDICS, Moncalieri, Turin, Italy) reconstruction based on multiparametric magnetic resonance imaging (mpMRI) and superimposed imaging during augmented-reality robot-assisted radical prostatectomy (AR-RARP). ConclusionOur results suggest that a HA3D virtual reconstruction of the prostate based on mpMRI data and real-time superimposed imaging allow performance of an effective AR-RARP. Potentially, this approach translates into better outcomes, as the surgeon can tailor the procedure for each patient.

show abstract

“…Moreover, interesting clinical results were obtained by Porpiglia and colleagues reporting a clinical trial in which they tested chitosan membrane, already known for its effectiveness in promoting nerve regeneration [117], as protective device for neurovascular bundles following bilateral nerve-sparing radical prostatectomy [94].…”

Section: Discussionmentioning

confidence: 99%

“…In order to improve the regeneration process and the functional recovery of peripheral nerves, different artificial devices have been developed and proposed for clinical application [71,92,93]. Interestingly, the application of membranes made of another biomaterial of natural origin namely chitosan has been reported to be safe and effective on the neurovascular bundles after nerve-sparing robot-assisted radical prostatectomy, appreciating also some positive results regarding potency recovery [94].…”

Section: Application Of Chitosan Membrane To Improve the Functional Rmentioning

confidence: 99%

Strategies to improve nerve regeneration after radical prostatectomy: a narrative review

Geuna¹,

Muratori²,

Fregnan³

et al. 2018

Minerva Urol Nefrol

Self Cite

View full text Add to dashboard Cite

Peripheral nerves are complex organs that spread throughout the entire human body. They are frequently affected by lesions not only as a result of trauma but also following radical tumor resection. In fact, despite the advancement in surgical techniques, such as nervesparing robot assisted radical prostatectomy, some degree of nerve injury may occur resulting in erectile dysfunction with significant impairment of the quality of life.The aim of this review is to provide an overview on the mechanisms of the regeneration of injured peripheral nerves and to describe the potential strategies to improve the regeneration process and the functional recovery. Yet, the recent advances in bioengineering strategies to promote nerve regeneration in the urological field are outlined with a view on the possible future regenerative therapies which might ameliorate the functional outcome after radical prostatectomy.

show abstract

Chitosan membranes applied on the prostatic neurovascular bundles after nerve‐sparing robot‐assisted radical prostatectomy: a phase II study

Cited by 19 publications

References 27 publications

Use of chitosan membranes after nerve‐sparing radical prostatectomy improves early recovery of sexual potency: results of a comparative study

Use of chitosan membranes after nerve‐sparing radical prostatectomy improves early recovery of sexual potency: results of a comparative study

Augmented‐reality robot‐assisted radical prostatectomy using hyper‐accuracy three‐dimensional reconstruction (HA3D™) technology: a radiological and pathological study

Strategies to improve nerve regeneration after radical prostatectomy: a narrative review

Contact Info

Product

Resources

About