AI Article Synopsis
- The study explored the use of spider silk for reconstructing erectile nerves in patients undergoing robotic prostate surgery.
- The method involved placing spider silk on neurovascular bundles after prostate removal, and outcomes showed that inflammatory markers were stabilized without major complications.
- Three out of six patients reported improved erectile function within three months, suggesting spider silk is a safe approach, but further research is needed to solidify these results.
Article Abstract
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.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10189231 | PMC |
| http://dx.doi.org/10.1007/s00345-023-04427-7 | DOI Listing |
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