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The application of tissue-engineered preputial matrix and fibrin sealant for urethral reconstruction in rabbit model

  • Urology - Original Paper
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Abstract

Background

To introduce the role of fibrin sealant and preputial acellular matrix (PAM) as a new source of inert collagen matrix for urethral reconstruction.

Methods

A ventral urethral segmental defect was created in 24 male rabbits divided into four groups. In group 1 (G1), urethrotomy was closed in layers. In group 2 (G2), closure was followed by applying fibrin sealant. In groups 3 (G3) and 4 (G4), urethroplasty was performed with a patch graft of PAM, and in G4, fibrin sealant was also applied. Serial urethrography was performed before and after the operation. Then, the animals were euthanized, and their urethra was excised 1, 3, and 9 months postoperatively for further electron microscopic examination, terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) technique, and immunohistochemical (IHC) staining with CD34, CD31, desmin, SMA, and α-actin.

Results

In G1 and G2, the fistula repair failed in all the time points. In G3 and G4, serial urethrography confirmed the maintenance of a wide urethral caliber without signs of strictures or extravasations. Satisfactory vascularity was observed in G3 and G4 during the whole study, which was more significant in G4 after 9 months of follow-up. The presence of a complete transitional cell layer was confirmed over the graft in G3 and G4 in all time points. IHC staining confirmed the effectiveness of fistula repair in G3 and G4, 3 months postoperatively.

Conclusion

This rabbit model showed that PAM combined with fibrin sealant may herald a reliable option for repairing segmental urethral defects.

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References

  1. Aulagne M, Harper L, de Napoli-Cocci S, Bondonny J, Dobremez E (2010) Long-term outcome of severe hypospadias. J Pediatr Urol 6(5):469–472

    Article  CAS  PubMed  Google Scholar 

  2. Snodgrass W, Macedo A, Hoebeke P, Mouriquand PD (2011) Hypospadias dilemmas: a round table. J Pediatr Urol 7(2):145

    Article  PubMed  Google Scholar 

  3. Raya-Rivera A, Esquiliano DR, Yoo JJ, Lopez-Bayghen E, Soker S, Atala A (2011) Tissue-engineered autologous urethras for patients who need reconstruction: an observational study. Lancet 377(9772):1175–1182

    Article  PubMed Central  PubMed  Google Scholar 

  4. Yang B, Peng B, Zheng J (2011) Cell-based tissue-engineered urethras. Lancet 378(9791):568–569

    Article  PubMed  Google Scholar 

  5. Palminteri E, Berdondini E, Colombo F, Austoni E (2007) Small intestinal submucosa (SIS) graft urethroplasty: short-term results. Eur Urol 51(6):1695–1701

    Article  PubMed  Google Scholar 

  6. Sievert K-D (2011) The next step in urethral reconstruction. Lancet 377(9772):1130–1131

    Article  PubMed  Google Scholar 

  7. Evans LA, Morey AF (2006) Current applications of fibrin sealant in urologic surgery. Int Braz J Urol 32(2):131–141

    Article  PubMed  Google Scholar 

  8. Kajbafzadeh A-M, Abolghasemi H, Eshghi P, Alizadeh F, Elmi A, Shafaattalab S et al (2011) Single-donor fibrin sealant for repair of urethrocutaneous fistulae following multiple hypospadias and epispadias repairs. J Pediatr Urol 7(4):422–427

    Article  PubMed  Google Scholar 

  9. Gopal SC, Gangopadhyay AN, Mohan TV, Upadhyaya VD, Pandey A, Upadhyaya A et al (2008) Use of fibrin glue in preventing urethrocutaneous fistula after hypospadias repair. J Pediatr Surg 43(10):1869–1872

    Article  PubMed  Google Scholar 

  10. Oosterlinck W, Cheng H, Hoebeke P, Verbeeck R (1993) Watertight sutures with fibrin glue: an experimental study. Eur Urol 23(4):481–484

    CAS  PubMed  Google Scholar 

  11. Roberts J (2010) Hypospadias surgery past, present and future. Curr Opin Urol 20(6):483–489

    Article  PubMed  Google Scholar 

  12. Baskin LS, Ebbers MB (2006) Hypospadias: anatomy, etiology, and technique. J Pediatr Surg 41(3):463–472

    Article  PubMed  Google Scholar 

  13. Manzoni G, Bracka A, Palminteri E, Marrocco G (2004) Hypospadias surgery: when, what and by whom? BJU Int 94(8):1188–1195

    Article  PubMed  Google Scholar 

  14. Bracka A (2011) Buccal mucosa: good but not perfect. J Urol 185(3):777–778

    Article  PubMed  Google Scholar 

  15. Sievert K-D, Amend B, Stenzl A (2007) Tissue engineering for the lower urinary tract: a review of a state of the art approach. Eur Urol 52(6):1580–1589

    Article  PubMed  Google Scholar 

  16. Mantovani F, Trinchieri A, Mangiarotti B, Nicola M, Castelnuovo C, Confalonieri S et al (2002) Reconstructive urology. Arch Ital Urol Androl 74:127–128

    PubMed  Google Scholar 

  17. Badylak SF, Lantz GC, Coffey A, Geddes LA (1989) Small intestinal submucosa as a large diameter vascular graft in the dog. J Surg Res 47(1):74–80

    Article  CAS  PubMed  Google Scholar 

  18. Sandusky G Jr, Badylak S, Morff R, Johnson W, Lantz G (1992) Histologic findings after in vivo placement of small intestine submucosal vascular grafts and saphenous vein grafts in the carotid artery in dogs. Am J Pathol 140(2):317

    PubMed Central  PubMed  Google Scholar 

  19. De Filippo RE, Yoo JJ, Atala A (2002) Urethral replacement using cell seeded tubularized collagen matrices. J Urol 168(4):1789–1793

    Article  PubMed  Google Scholar 

  20. Fossum M, Svensson J, Kratz G, Nordenskjöld A (2007) Autologous in vitro cultured urothelium in hypospadias repair. J Pediatr Urol 3(1):10–18

    Article  CAS  PubMed  Google Scholar 

  21. Ambriz-González G, Velázquez-Ramírez GA, García-González JL, de León-Gómez JMG, Muciño-Hernández MI, González-Ojeda A et al (2007) Use of fibrin sealant in hypospadias surgical repair reduces the frequency of postoperative complications. Urol Int 78(1):37–41

    Article  PubMed  Google Scholar 

  22. Hick EJ, Morey AF (2004) Initial experience with fibrin sealant in pendulous urethral reconstruction. Is early catheter removal possible? J Urol 171(4):1547–1549

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

No conflict of interest exists in relation to the submitted manuscript, and there was no source of extra-institutional commercial funding or funding received from National Institutes of Health (NIH), Wellcome Trust, Howard Hughes Medical Institute (HHMI), and others.

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Authors and Affiliations

  1. Pediatric Urology Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children’s Hospital Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Qarib’s Street, Keshavarz Boulevard, Tehran, 1419433151, Iran

    Abdol-Mohammad Kajbafzadeh, Shabnam Sabetkish, Azadeh Elmi, Saman Shafaat Talab & Mohammad Javad Mohseni

  2. Division of Pediatric Urology, Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, MD, USA

    Ali Tourchi

  3. Iranian National Blood Bank, Research Center, Iranian Blood Transfusion Organization, Tehran, Iran

    Naser Amirizadeh, Hassan Abolghasemi & Peyman Eshghi

  4. Division of Urology, Department of Urologic Sciences, BC Children’s Hospital, Vancouver, Canada

    Kourosh Afshar

Authors
  1. Abdol-Mohammad Kajbafzadeh
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  2. Shabnam Sabetkish
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  3. Ali Tourchi
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  4. Naser Amirizadeh
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  5. Kourosh Afshar
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  6. Hassan Abolghasemi
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  7. Azadeh Elmi
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  8. Saman Shafaat Talab
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  9. Peyman Eshghi
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  10. Mohammad Javad Mohseni
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Corresponding author

Correspondence to Abdol-Mohammad Kajbafzadeh.

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Kajbafzadeh, AM., Sabetkish, S., Tourchi, A. et al. The application of tissue-engineered preputial matrix and fibrin sealant for urethral reconstruction in rabbit model. Int Urol Nephrol 46, 1573–1580 (2014). https://doi.org/10.1007/s11255-014-0684-3

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  • DOI: https://doi.org/10.1007/s11255-014-0684-3

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