Yun-Jung Yang, Taehyen Kim, Eun-Jung Yang, Se Young Choi
{"title":"脱水人羊膜/绒毛膜在机器人辅助根治性前列腺切除术后增强功能预后中的作用：一项系统综述和荟萃分析。","authors":"Yun-Jung Yang, Taehyen Kim, Eun-Jung Yang, Se Young Choi","doi":"10.1093/jsxmed/qdae199","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Dehydrated human amnion/chorion membrane (dHACM) has shown potential in enhancing neurovascular recovery and functional outcomes in robot-assisted radical prostatectomy (RARP).</p><p><strong>Aim: </strong>To evaluate the effects of dHACM on continence recovery, sexual function, and oncological outcomes in patients undergoing RARP.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA guidelines, analyzing data from PubMed, Cochrane, and EMBASE. Six retrospective studies comparing RARP with and without dHACM were included. Odds ratios (OR) and standardized mean differences (SMD) were calculated using a random-effects model.</p><p><strong>Outcomes: </strong>The primary outcomes were continence and potency recovery, and secondary outcomes included biochemical recurrence (BCR).</p><p><strong>Results: </strong>The meta-analysis included 4072 patients (1699 experimental and 2373 control). dHACM significantly improved early continence recovery (SMD 1.78, 95% CI 1.26-2.34) at <3, 3, and 6 months postoperatively (OR 1.95, 95% CI 1.13-3.36; OR 2.17, 95% CI 1.52-3.09; and OR 1.70, 95% CI 1.10-2.63, respectively). Time to potency recovery was shorter (SMD -0.55, 95% CI -0.67 to -0.43), with significant improvements at <3, 3, 6, and 9 months (OR 1.67, 95% CI 1.25-2.23; OR 1.27, 95% CI 1.06-1.53; OR 1.41, 95% CI 1.15-1.72; and OR 1.51, 95% CI 1.16-1.97, respectively). There were no significant differences in BCR (OR 0.85, 95% CI 0.54-1.35).</p><p><strong>Clinical implications: </strong>dHACM offers potential as an adjunct to enhance functional recovery following RARP without compromising oncologic safety, but further high-quality studies are needed.</p><p><strong>Strengths & limitations: </strong>Strengths include a comprehensive analysis of early functional outcomes and low heterogeneity in early potency and continence data. Limitations include reliance on retrospective studies and lack of randomized controlled trials.</p><p><strong>Conclusion: </strong>dHACM may accelerate continence and sexual function recovery in early period after RARP while maintaining oncological outcomes, but further randomized studies are necessary to confirm these findings.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Role of dehydrated human amnion/chorion membrane in enhancing functional outcomes after robot-assisted radical prostatectomy: a systematic review and meta-analysis.\",\"authors\":\"Yun-Jung Yang, Taehyen Kim, Eun-Jung Yang, Se Young Choi\",\"doi\":\"10.1093/jsxmed/qdae199\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Dehydrated human amnion/chorion membrane (dHACM) has shown potential in enhancing neurovascular recovery and functional outcomes in robot-assisted radical prostatectomy (RARP).</p><p><strong>Aim: </strong>To evaluate the effects of dHACM on continence recovery, sexual function, and oncological outcomes in patients undergoing RARP.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA guidelines, analyzing data from PubMed, Cochrane, and EMBASE. Six retrospective studies comparing RARP with and without dHACM were included. Odds ratios (OR) and standardized mean differences (SMD) were calculated using a random-effects model.</p><p><strong>Outcomes: </strong>The primary outcomes were continence and potency recovery, and secondary outcomes included biochemical recurrence (BCR).</p><p><strong>Results: </strong>The meta-analysis included 4072 patients (1699 experimental and 2373 control). dHACM significantly improved early continence recovery (SMD 1.78, 95% CI 1.26-2.34) at <3, 3, and 6 months postoperatively (OR 1.95, 95% CI 1.13-3.36; OR 2.17, 95% CI 1.52-3.09; and OR 1.70, 95% CI 1.10-2.63, respectively). Time to potency recovery was shorter (SMD -0.55, 95% CI -0.67 to -0.43), with significant improvements at <3, 3, 6, and 9 months (OR 1.67, 95% CI 1.25-2.23; OR 1.27, 95% CI 1.06-1.53; OR 1.41, 95% CI 1.15-1.72; and OR 1.51, 95% CI 1.16-1.97, respectively). There were no significant differences in BCR (OR 0.85, 95% CI 0.54-1.35).</p><p><strong>Clinical implications: </strong>dHACM offers potential as an adjunct to enhance functional recovery following RARP without compromising oncologic safety, but further high-quality studies are needed.</p><p><strong>Strengths & limitations: </strong>Strengths include a comprehensive analysis of early functional outcomes and low heterogeneity in early potency and continence data. Limitations include reliance on retrospective studies and lack of randomized controlled trials.</p><p><strong>Conclusion: </strong>dHACM may accelerate continence and sexual function recovery in early period after RARP while maintaining oncological outcomes, but further randomized studies are necessary to confirm these findings.</p>\",\"PeriodicalId\":51100,\"journal\":{\"name\":\"Journal of Sexual Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-01-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Sexual Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/jsxmed/qdae199\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Sexual Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jsxmed/qdae199","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Role of dehydrated human amnion/chorion membrane in enhancing functional outcomes after robot-assisted radical prostatectomy: a systematic review and meta-analysis.
Background: Dehydrated human amnion/chorion membrane (dHACM) has shown potential in enhancing neurovascular recovery and functional outcomes in robot-assisted radical prostatectomy (RARP).
Aim: To evaluate the effects of dHACM on continence recovery, sexual function, and oncological outcomes in patients undergoing RARP.
Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines, analyzing data from PubMed, Cochrane, and EMBASE. Six retrospective studies comparing RARP with and without dHACM were included. Odds ratios (OR) and standardized mean differences (SMD) were calculated using a random-effects model.
Outcomes: The primary outcomes were continence and potency recovery, and secondary outcomes included biochemical recurrence (BCR).
Results: The meta-analysis included 4072 patients (1699 experimental and 2373 control). dHACM significantly improved early continence recovery (SMD 1.78, 95% CI 1.26-2.34) at <3, 3, and 6 months postoperatively (OR 1.95, 95% CI 1.13-3.36; OR 2.17, 95% CI 1.52-3.09; and OR 1.70, 95% CI 1.10-2.63, respectively). Time to potency recovery was shorter (SMD -0.55, 95% CI -0.67 to -0.43), with significant improvements at <3, 3, 6, and 9 months (OR 1.67, 95% CI 1.25-2.23; OR 1.27, 95% CI 1.06-1.53; OR 1.41, 95% CI 1.15-1.72; and OR 1.51, 95% CI 1.16-1.97, respectively). There were no significant differences in BCR (OR 0.85, 95% CI 0.54-1.35).
Clinical implications: dHACM offers potential as an adjunct to enhance functional recovery following RARP without compromising oncologic safety, but further high-quality studies are needed.
Strengths & limitations: Strengths include a comprehensive analysis of early functional outcomes and low heterogeneity in early potency and continence data. Limitations include reliance on retrospective studies and lack of randomized controlled trials.
Conclusion: dHACM may accelerate continence and sexual function recovery in early period after RARP while maintaining oncological outcomes, but further randomized studies are necessary to confirm these findings.
期刊介绍：
The Journal of Sexual Medicine publishes multidisciplinary basic science and clinical research to define and understand the scientific basis of male, female, and couples sexual function and dysfunction. As an official journal of the International Society for Sexual Medicine and the International Society for the Study of Women''s Sexual Health, it provides healthcare professionals in sexual medicine with essential educational content and promotes the exchange of scientific information generated from experimental and clinical research.
The Journal of Sexual Medicine includes basic science and clinical research studies in the psychologic and biologic aspects of male, female, and couples sexual function and dysfunction, and highlights new observations and research, results with innovative treatments and all other topics relevant to clinical sexual medicine.
The objective of The Journal of Sexual Medicine is to serve as an interdisciplinary forum to integrate the exchange among disciplines concerned with the whole field of human sexuality. The journal accomplishes this objective by publishing original articles, as well as other scientific and educational documents that support the mission of the International Society for Sexual Medicine.
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