Spider silk erectile nerve reconstruction in robot-assisted radical prostatectomy : a first-in-men feasibility analysis
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature..
PURPOSE: To investigate the safety and feasibility of spider silk interposition for erectile nerve reconstruction in patients undergoing robotic radical prostatectomy (RARP).
METHODS: The major-ampullate-dragline from Nephila edulis was used for spider silk nerve reconstruction (SSNR). After removal of the prostate with either uni- or bilateral nerve-sparing, the spider silk was laid out on the site of the neurovascular bundles. Data analysis included inflammatory markers and patient reported outcomes.
RESULTS: Six patients underwent RARP with SSNR. In 50% of the cases, only a unilateral nerve-sparing was performed, bilateral nerve-sparing could be performed in three patients. Placement of the spider silk conduit was uneventful, contact of the spider silk with the surrounding tissue was mostly sufficient for a stable connection with the proximal and distal ends of the dissected bundles. Inflammatory markers peaked until postoperative day 1 but stabilized until discharge without any need for antibiotic treatment throughout the hospital stay. One patient was readmitted due to a urinary tract infection. Three patients reported about erections sufficient for penetration after three months with a continuous improvement of erectile function both after bi- and unilateral nerve-sparing with SSNR up to the last follow-up after 18 months.
CONCLUSION: In this analysis of the first RARP with SSNR, a simple intraoperative handling without major complications was demonstrated. While the series provides evidence that SSNR is safe and feasible, a prospective randomized trial with long-term follow-up is needed to identify further improvement in postoperative erectile function due to the spider silk-directed nerve regeneration.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:41 |
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| Enthalten in: |
World journal of urology - 41(2023), 6 vom: 17. Juni, Seite 1481-1487 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Harke, Nina N [VerfasserIn] |
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| Links: |
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| Themen: |
Erectile dysfunction |
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| Anmerkungen: |
Date Completed 07.06.2023 Date Revised 07.06.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00345-023-04427-7 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM356978923 |
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| 245 | 1 | 0 | |a Spider silk erectile nerve reconstruction in robot-assisted radical prostatectomy |b a first-in-men feasibility analysis |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. | ||
| 520 | |a PURPOSE: To investigate the safety and feasibility of spider silk interposition for erectile nerve reconstruction in patients undergoing robotic radical prostatectomy (RARP) | ||
| 520 | |a METHODS: The major-ampullate-dragline from Nephila edulis was used for spider silk nerve reconstruction (SSNR). After removal of the prostate with either uni- or bilateral nerve-sparing, the spider silk was laid out on the site of the neurovascular bundles. Data analysis included inflammatory markers and patient reported outcomes | ||
| 520 | |a RESULTS: Six patients underwent RARP with SSNR. In 50% of the cases, only a unilateral nerve-sparing was performed, bilateral nerve-sparing could be performed in three patients. Placement of the spider silk conduit was uneventful, contact of the spider silk with the surrounding tissue was mostly sufficient for a stable connection with the proximal and distal ends of the dissected bundles. Inflammatory markers peaked until postoperative day 1 but stabilized until discharge without any need for antibiotic treatment throughout the hospital stay. One patient was readmitted due to a urinary tract infection. Three patients reported about erections sufficient for penetration after three months with a continuous improvement of erectile function both after bi- and unilateral nerve-sparing with SSNR up to the last follow-up after 18 months | ||
| 520 | |a CONCLUSION: In this analysis of the first RARP with SSNR, a simple intraoperative handling without major complications was demonstrated. While the series provides evidence that SSNR is safe and feasible, a prospective randomized trial with long-term follow-up is needed to identify further improvement in postoperative erectile function due to the spider silk-directed nerve regeneration | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Erectile dysfunction | |
| 650 | 4 | |a Nerve graft | |
| 650 | 4 | |a Potency recovery | |
| 650 | 4 | |a Radical prostatectomy | |
| 650 | 4 | |a Robotic surgery | |
| 650 | 4 | |a Spider silk | |
| 700 | 1 | |a Strauss, Sarah |e verfasserin |4 aut | |
| 700 | 1 | |a Peters, Inga |e verfasserin |4 aut | |
| 700 | 1 | |a Katzendorn, Olga |e verfasserin |4 aut | |
| 700 | 1 | |a Tezval, Hossein |e verfasserin |4 aut | |
| 700 | 1 | |a Kuczyk, Markus A |e verfasserin |4 aut | |
| 700 | 1 | |a Vogt, Peter M |e verfasserin |4 aut | |
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