Poster, Podium & Video Sessions
Presentation Authors: Joao Zambon*, Manish Patel, Ashok Hemal, Gopal Badlani, Ashley Dean, Shannon Lankford, Koudy Williams, Winston-Salem, NC
Introduction: Prevention of urinary incontinence (UI) and erectile dysfunction (ED) during healing following radical prostatectomy is poorly understood. A reproducible animal model that mimics human anatomy such as intrapelvic bladder, similar genitourinary system, an upright posture with ability to simulate the radical prostatectomy was the first step. Second, was to develop a reproducible, subjectively and objectively quantifiable, model of UI and ED after open radical prostatectomy (ORP) using Cynomologus monkeys at the age equivalent to middle aged men.
Methods: Ten monkeys were used; two for the anatomical study & feasibility of doing ORP and eight underwent ORP. Animals were sacrificed at 6 months follow up. UI was evaluated through, observed voiding behavior, & urodynamics performed before, 3 and 6 months after ORP. At 3 and 6 months postop, phenazopyridine was added to their juice to demonstrate observed urinary leakage. Erectile Function was assessed before, 3 and 6 months after ORP by intra-cavernosal (IC) pressure measurement after IC papaverine injection. Sexual behavior was video-monitored at the same time points. The following parameters were analyzed: mounting, thrusting and erection. CT scan was done at 3 and 6 months postop to evaluate urethral anastomosis. After being sacrificed specimens were collected for histology.
Results: At 3 (N=8) and 6 (N=4) months after ORP all monkeys had UI and ED. There was a statistically significant decrease in abdominal leak point pressure (Table 1) at 3 & 6 months follow up, and a decline in the IC pressure after IC injection (Graph 1). Animals were not able to achieve erection when placed with a female partner. CT scan showed intact bladder-urethral anastomosis and Mason trichrome staining demonstrated peri-urethral fibrosis.
Conclusions: This is the first reported long-term NHP model of UI and ED after open radical prostatectomy. This model can help in developing new strategies for prevention and treatment with novel approaches.
Source Of Funding: R01 DK083688
Saturday, May 13
7:00 AM – 9:00 AM