AUA 2017: Effect of Dehydrated Human Amnion / Chorion Membrane Allograft on Urinary Continence Following Robot-Assisted Radical Prostatectomy (RARP)
AmnioFix was applied to 138 (38%) patients undergoing RARP at an academic center, with the primary goal of decreasing time to continence recovery. In both time to pad-free status and overall pad status at follow-up, AmnioFix appeared to be advantageous. Those in the AmnioFix group reached pad-free continence at a mean of 2.84 months (64% reached <1 pads within 6 months), while the control group took an average of 3.20 months (only 48% reaching <1 pads within 6 months). After adjusting for PSA, prostate weight, nerve sparing, age, race, and CAPRA risk, AmnioFix significantly increased the likelihood of using <1 pads within 12 months post-RP (HR: 1.52, 95% CI: 1.10 to 2.10, p=0.011).
Overall, this study was most limited by its retrospective nature and small sample size. The majority of RARPs performed with AmnioFix were done by a single surgeon at a single institution, preventing analysis of surgeon-dependent influencers. Further, nerve-sparing status and age were also independent predictors of better continence return following RARP. While the pre-emptive mitigation of injury to the NVB may be advantageous, nerve-sparing and age remain important determinant factors for continence. A multi-institutional, randomize control trial is necessary to evaluate the full impact of AmnioFix, after controlling for inter- and intra- surgeon factors.
Authors: Khaled Refaai, Hao Nguyen*, Ameli Niloufar, Wang Huiqing, Matthew Cooperberg, Peter Carroll, San Francisco, CA
Presented by: Hao Nguyen (MD) the University of California, San Francisco
Written By: Linda Huynh (BS), an assistant research specialist from the University of California, Irvine, on behalf of UroToday.com
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA