Urethroplasty using autologous urethral tissue-embedded acellular porcine bladder submucosa matrix grafts for the management of long-segment urethral stricture in a rabbit model.
We conducted this study to evaluate the combined effect of acellular bladder submucosa matrix (BSM) and autologous urethral tissue for the treatment of long segment urethral stricture in a rabbit model. To prepare the BSM, porcine bladder submucosa was processed, decellularized, configured into a sheet-like shape, and sterilized. Twenty rabbits were randomized to normal control, urethral stricture, urethroplasty using BSM only or BSM/autologous urethral tissue (n=5 per group). Retrograde urethrography was performed at 4, 8, and 12 weeks postoperatively, and the grafted specimens were harvested at week 12 to evaluate urethral reconstruction through histopathologic and immunohistochemical analysis. The mean urethral width of the control, stricture, BSM, and BSM/autologous urethral tissue groups at week 12 was 10.3±0.80, 3.8±1.35, 8.8±0.84, and 9.1±1.14 mm, respectively. The histopathologic study revealed that the BSM/autologous urethral tissue graft had a normal area of urethral lumen, compact muscular layers, complete epithelialization, and progressive infiltration by vessels in the regenerated urethra. In contrast, the BSM grafts revealed keratinized epithelium, abundant collagenized fibrous connective tissue, and were devoid of bundles of circular smooth muscle. Nontransected ventral onlay-augmented urethroplasty using an acellular BSM scaffold combined with an autologous urethral tissue graft represents a feasible procedure for urethral reconstruction.
Joint Institute for Regenerative Medicine, Kyungpook National University Hospital, Daegu, Korea.
So Young
0000-0003-4500-4956
SY
Chun
Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea.
Bum Soo
0000-0002-4873-3049
BS
Kim
Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea.
Se Yun
0000-0003-1147-8037
SY
Kwon
Laboratory Animal Center, Yeungnam University, Daegu, Korea.
Sung Il
0000-0003-1908-9044
SI
Park
Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea.
Phil Hyun
0000-0002-3801-258X
PH
Song
Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea.
Eun Sang
0000-0002-7442-6886
ES
Yoo
Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea.
Bup Wan
0000-0001-5953-3459
BW
Kim
Joint Institute for Regenerative Medicine, Kyungpook National University Hospital, Daegu, Korea. ; Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea.
Tae Gyun
0000-0002-4390-0952
TG
Kwon
Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea.
Hyun Tae
0000-0002-4730-3776
HT
Kim
D000818:Animals; D004848:Epithelium / Q000601:surgery; D009092:Mucous Membrane / Q000166:cytology / Q000637:transplantation*; D009130:Muscle, Smooth / Q000601:surgery; D011817:Rabbits; D019651:Plastic Surgery Procedures / Q000379:methods; D013552:Swine; D023822:Tissue Engineering; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D001743:Urinary Bladder / Q000166:cytology*
Grafts; Rabbits; Urethra; Urethral Stricture; Urinary Bladder