EFFICACY OF INTRAOPERATIVE ARISTA POLYSACCHARIDE APPLICATION ON THE POSTOPERATIVE BLOOD LOSS IN PATIENTS UNDERGOING RARP FOR THE TREATMENT OF PROSTATE CANCER

Prior treatment

• Suspected bone or visceral metastases at preoperative imaging Neoadjuvant androgen deprivation therapy
• Any prior local therapy of the prostate (including subvesical deobstruction or radiation therapy)
• Any prior chemotherapy or colon/rectal surgery
• Any prior pelvic trauma that required surgical intervention
• Bilateral secondary (complete or partial) resection of the neurovascular bundle
• No contraindications for phosphodiesterase type 5 inhibitor intake (i.e. suited for most penile rehabilitation regimes)
• No surgical revision within 7d after RARP (Clavien Dindo classified complication ≥3b)

Other illness

• High risk prostate cancer (PSA ≥ 20 ng/ml or biopsy Gleason-Score ≥ 8 or suspected T4)
• Depression or other psychological or neurological disease (dementia, schizophrenia, bipolar disorder etc.)
• Peyronie's disease
• Any endocrine function disorder (not including diabetes)
  • SURGICAL AND PERIOPERATIVE EXLUSION CRITERIA:
• For a) nerve sparing and b) controlling bleeding in the area of the prostate bed and neurovascular bundles after prostate removal, no monopolar thermal application are allowed but suturing and clip application is allowed. For secondary resection of the neurovascular bundle and controlling bleeding, mono- or bipolar thermal application, clip application and suturing is allowed.

Other

• Severe intellectual limitations preventing to fully understand the study concept and its content
• Polyneuropathia
• IPSS Score \>19 and QoL \>3
• Accessory pudendal arteries (APA) preservation, if an APA is identified
• No definitive anastomotic partial or complete rupture (identified via cystogram within 30d after RARP)

• Age range ≥ 45 to ≥68 yrs
• Biopsy proven prostate cancer treated with robotic-assisted radical prostatectomy
• Intrafascial nerve sparing surgery (unilaterally or bilaterally)
• Preoperative urinary continence
• Group A Preoperative unassisted International Index of Erectile function (IIEF)-5 score range 8-16 (i.e. moderate (8-11) and mild to moderate (12-16))