title: Use of a fibrovascular tube in creation of neo-urethra during penile reconstruction.
abstract: BACKGROUND
  There are several techniques employed in the surgical treatment of total or partial penile reconstruction, hypospadias surgery, and urethral stricture. Urethral reconstruction is performed in different ways applying these techniques.
  
  
  OBJECTIVE
  We evaluated use of a fibrovascular sheath to create a neo-urethra formed around a silicon tube.
  
  
  METHODS
  We used nine male New Zealand rabbits for this study. In the first step, we placed a silicone tube under the skin in the lower abdomen of the rabbits and waited for the formation of a fibrovascular sheath to totally surround the tube. In the second step, the silicone tube was removed and the formed fibrovascular sheath was anastomosed with penile urethra over a silicone 8F Foley catheter. Ten days after the second step, the silicone Foley catheter was removed. Twenty days after the second step, we evaluated the newly created neo-urethra with a retrograde urethrogram. Thirty days after the second step, the rabbits were sacrificed and the bladder, urethra, and neo-urethra were removed for histopathological examination.
  
  
  RESULTS
  Six of the rabbits completed the study. After the first operation, in the third month, formation of the fibrovascular sheath was observed around the silicon tube. After anastomosis and removal of the silicon Foley catheter, urine was seen to pass through the neo-urethral meatus. Urethrocystography showed that the neo-urethra and penile urethra were aligned and urine flow was regular. Histopathological evaluation showed that the structural integrity of the newly formed urethra was comparable with the structure of the regular urethra (Table) and the calibration did not change over time, although the newly formed urethra was not covered with uroepithelium.
  
  
  CONCLUSIONS
  In this study, we achieved promising results with use of a newly formed fibrovascular sheath as a neo-urethra.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Electronic address: drakyapici@gmail.com.
authors.forename: Abdul Kerim
authors.initials: AK
authors.lastname: Yapici
authors.affiliation: Department of Urology, Gulhane Military Medical Academy, Ankara, Turkey.
authors.forename: Sami
authors.initials: S
authors.lastname: Uguz
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey.
authors.forename: Yalcin
authors.initials: Y
authors.lastname: Bayram
authors.affiliation: Department of Radiology, Gulhane Military Medical Academy, Ankara, Turkey.
authors.forename: Sebahattin
authors.initials: S
authors.lastname: Sari
authors.affiliation: Department of Pathology, Gulhane Military Medical Academy, Ankara, Turkey.
authors.forename: Yildirim
authors.initials: Y
authors.lastname: Karslioglu
authors.affiliation: Department of Pediatric Surgery, Gulhane Military Medical Academy, Ankara, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Guven
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Ozturk
mesh_terms: D000818:Animals; D001187:Artificial Organs; D008297:Male; D010413:Penis / Q000601:surgery*; D011817:Rabbits; D019651:Plastic Surgery Procedures / Q000379:methods*; D012828:Silicones; D014521:Urethra; D062885:Urinary Catheters
chemical_list: D012828:Silicones
keywords: Fibrovascular tube; Neourethra; Silicon catheter; Urethral reconstruction