title: A Novel Experimental Method for Penile Augmentation Urethroplasty With a Combination of Buccal Mucosa and Amniotic Membrane in a Rabbit Model.
abstract: To investigate the results of penile urethral reconstruction using amniotic membrane (AM) and buccal mucosa (BM) grafts, and the simultaneous use of both in a rabbit model.
  
  
  
  A total of 28 male rabbits were divided into 4 groups according to grafting style: group 1 (AM), group 2 (BM), group 3 (BM + AM), and group 4 (sham). A standardized urethral defect was created in the 3 initial groups. The sham group underwent only a ventral vertical urethral incision and primary re-suturation. AM grafts were used in group 1, and BM grafts were used in groups 2 and 3. AM grafts were affixed to the BM grafts in group 3 as a covering tissue. Urethrography and endoscopy were performed after the 1st and 2nd months of grafting. The penises were subjected to histopathologic and immunohistochemical assessment for fibroblast growth factor and vascular endothelial growth factor expression.
  
  
  
  Dehiscence and fistula developed in group 1, whereas 2 fistulas were observed in group 2. No complications developed in group 3. Epithelization at urethras was observed at 4 weeks in all groups, but transformation to urothelial epithelialization occurred at 8 weeks. Marked amelioration and epithelial transformation were observed in group 3. The most prominent fibroblast growth factor expression was observed in group 3. Vascular endothelial growth factor expression was completely negative in group 3 at 8 weeks, indicating complete healing.
  
  
  
  The simultaneous use of AM and BM for ventral onlay penile urethroplasty provides better tissue healing and lower complication rates in comparison to BM alone. Further animal studies or clinical applications are needed.
authors.affiliation: Department of Urology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey. Electronic address: drmgunes@hotmail.com.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Güneş
authors.affiliation: Department of Urology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.
authors.forename: Muammer
authors.initials: M
authors.lastname: Altok
authors.affiliation: Department of Pathology, Faculty of Veterinary Medicine, Mehmet Akif Ersoy University, Burdur, Turkey.
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Özmen
authors.affiliation: Department of Urology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Umul
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.
authors.forename: Alime
authors.initials: A
authors.lastname: Güneş
authors.affiliation: Department of Urology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.
authors.forename: Ercan
authors.initials: E
authors.lastname: Baş
authors.affiliation: Department of Pathology, Faculty of Veterinary Medicine, Mehmet Akif Ersoy University, Burdur, Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Özyildiz
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey; Department of Oral and Maxillofacial Surgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.
authors.forename: Tolga Taha
authors.initials: TT
authors.lastname: Sönmez
authors.affiliation: Department of Biostatistics and Medical Informatics, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.
authors.forename: Hikmet
authors.initials: H
authors.lastname: Orhan
mesh_terms: D000650:Amnion / Q000637:transplantation*; D000818:Animals; D008297:Male; D008953:Models, Anatomic; D023421:Models, Animal; D009061:Mouth Mucosa / Q000637:transplantation*; D010413:Penis / Q000601:surgery*; D011817:Rabbits; D019651:Plastic Surgery Procedures / Q000379:methods*; D019737:Transplants / Q000637:transplantation; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D014945:Wound Healing