Erectile dysfunction (ED) following radical prostatectomy (RP) has a negative impact on quality of life. Herein, the aim was to assess the effectiveness of autologous adipose-derived regenerative cells (ADRCs) for treating ED after RP. This was a randomized, double-blinded, placebo-controlled study. A total of 70 men with ED were enrolled at Odense University Hospital, Denmark. Patients received one intracavernous bolus of ADRCs (n=35) or placebo (n=35). The primary endpoint was a change in the International Index of Erectile Function 5 (IIEF-5) at 12 mo after intervention versus baseline. The secondary endpoints were changes in Erectile Hardness Scale (EHS) and RigiScan values at 6 mo versus baseline. There was no significant difference between the two groups in IIEF-5 (p>0.99) and EHS (p=0.85) scores. RigiScan values showed no overall effect of ADRCs versus placebo (tumescence activity units at the tip of the penis p=0.19 and the base of the penis p=0.60, and rigidity activity units at the tip of the penis p=0.97 and the base of the penis p=1). No severe adverse events were observed, and none had prostate-specific antigen relapse. Study limitations include the use of online surveys for patient registration of IIEF-5 and EHS scores. Intracavernous injections of ADRCs appear safe, but had no measurable effect on ED after RP and thus cannot be recommended in its current form.

Robot-assisted partial nephrectomy (RAPN) is increasingly used to treat renal cell carcinoma (RCC), but randomized data comparing long-term outcomes to those after open partial nephrectomy (OPN) remain limited. Our aim was to compare oncological, renal function, and health-related quality of life (HRQOL) outcomes at 2yr for patients who underwent RAPN versus OPN. This single-center phase 2 randomized controlled trial included 50 patients with suspected localized RCC who were randomized 1:1 to RAPN or OPN. After 2-yr follow-up, we assessed overall survival (OS), recurrence-free survival, renal function, and HRQOL, including chronic postoperative pain and flank bulge. Analyses were conducted on an intention-to-treat basis. All but one patient completed oncological and renal follow-up, and 47 provided HRQOL data. At 2yr, overall survival was 100%, with one lymph-node recurrence in the RAPN group. The adjusted mean estimated glomerular filtration rate did not differ between the groups (OPN 74.1ml/min/1.73m2, 95% confidence interval [CI] 69.7-78.5; RAPN 75.8ml/min/1.73m2, 95% CI 71.3-80.1; p=0.59). HRQOL at 2yr remained high, with no significant difference in changes from baseline between the two groups. Chronic postoperative pain at the operative site (44% vs 0%; p=0.001) and flank bulge (32% vs 0%; p=0.007) were significantly more common in the OPN group versus the RAPN group. RAPN and OPN yielded excellent long-term outcomes. RAPN offers advantages in terms of postoperative morbidity without compromising renal function or QOL.