Wrapping dehydrated human amniotic membrane around nerve and anastomotic tissue during robotic prostatectomy was associated with faster recovery of erectile function, a 10-year, single-center study showed.

Among men who received the nerve wrap, the proportion of those who met the criteria for sexual potency rose from 75% at 3 months to 98% at 24 months. This increase was faster than that observed in men who received conventional care (60% at 3 months to 94% at 24 months), which the researchers called a statistically different trajectory over time (P < .05).

The difference was especially great among men older than 60 years at the time of the procedure, according to the researchers who submitted their findings to the European Association of Urology (EAU) 2026 Annual Meeting.

“This study represents, to my knowledge, the largest evaluation of dehydrated human amniotic membrane as an adjunct to potency recovery following robotic radical prostatectomy,” said Mani Menon, MD, director of the Precision Prostatectomy Program at Icahn School of Medicine at Mount Sinai in New York City, who was not associated with the research.

Prior smaller studies have also shown that dehydrated human amnion/chorion membrane can promote early return of potency after robot-assisted radical prostatectomy, according to a 2022 review published in Cancers. Observational results have also been positive with chitosan membrane as well as a hyaluronic acid-carboxymethyl cellulose membrane, the review added.

The new study was a retrospective review of a prospectively maintained single-center prostate cancer database of all men undergoing the nerve wrap procedure for robotic radical prostatectomy performed by Sanjay Razdan, MD, of the International Robotic Institute for Prostate Cancer in Doral, Florida. Razdan first described the use of the wrap in this setting in 2014. 

The analysis included 2560 men undergoing bilateral nerve-sparing procedures from 2014 to 2024. They were matched demographically, clinically, and biochemically to another 1495 men who underwent the same surgery without the nerve wrap.

Both groups were followed for an average of 8 years after surgery. 

Men achieved their first erection post-procedure after an average of 7 days with the nerve wrap compared with 14 days with standard care (P < .05).

Secondary findings showed a shorter time until erection sufficient for penetration in the nerve wrap group, averaging 21 days compared with 36 days in the control group (P < .05). 

Potency was defined as the ability to have satisfactory penetrative intercourse more than 50% of the time and a score of at least 17 on the Sexual Health Inventory for Men scale, which ranges from 1 to 25, with scores of 17 or higher indicating no more than mild erectile dysfunction.

The percentage of potent patients at 3, 6, 12, and 24 months was 75%, 87%, 98%, and 98%, respectively, in the nerve wrap group and 60%, 78%, 90%, 94%, respectively, in the control group (P < .05).

Complications and oncologic outcomes remained comparable between the two groups.

Menon pointed to “important methodological considerations,” including a lack of clarity on whether the data reflected cumulative incidence curves or cross-sectional analyses at each timepoint.

“This distinction is critical,” he said. “With an estimated 20%-30% loss to follow-up, a cumulative incidence approach using an inverse Kaplan-Meier method would be necessary to draw more reliable conclusions.”

The reported potency rates in both the control and study groups appeared relatively high compared with prior data, which typically ranged from 50% to 70% at 1-2 years with rigorous assessment, he added.

“While these findings are notable, the study remains observational and retrospective in nature,” Menon said. “Overall, these findings are intriguing and hypothesis generating. They underscore the need for well-designed randomized trials to determine whether dehydrated human amniotic membrane truly confers a meaningful benefit in postoperative potency recovery.”

The researchers provided no information on relevant financial relationships. Menon disclosed no relevant conflicts of interest.

Crystal Phend is an award-winning medical journalist with decades of experience reporting on clinical research and healthcare developments across specialties.