rates and erectile dysfunction. In this study, we investigated the feasibility of engineering corporal constructs using cavernosal smooth muscle (SMCs) and endothelial cells (ECs) seeded onto 3D acellular corporal collagen matrices. METHODS: Corpora cavernosa (CC) were isolated from nonhuman primates (NHPs). These specimens were then subjected to an established decellularization process to create acellular corporal collagen matrices. Autologous NHPs corporal SMCs and ECs were isolated, expanded in vitro, and seeded onto matrices via a multistep static/dynamic procedure.RESULTS: The corporal construct treated with the TritronX-100 protocol was effectively decellularized based on results of both DAPI (4,6 diamidino 2 phenylindole) staining and DNA assay (< 50 ng dsDNA/mg dry sample weight). Scanning electron microscopy of decellularized CC demonstrated highly porous 3D structure and structural integrity. Evenly distributed cellular attachment and phenotype of corporal ECs and SMCs before and after dynamic culture conditioning were evaluated by immunohistochemical staining with anti von Willebrand factor and anti-alpha smooth muscle actin.CONCLUSIONS: We have shown the feasibility of engineering viable and well-organized corpora cavernosa using tissue from NHPs. This represents an important achievement toward clinical utility for humans. Such technology may have application for selected cases of Peyronie disease associated with erectile dysfunction.
Introduction:The necessary transition to telehealth during COVID-19 generated new challenges for providers and patients, with the opportunity to exacerbate or mitigate standing care inequities. To better understand virtual medicine care delivery in urology, we sought to identify factors associated with appointment completion and use of telephone or video visits.Methods: We performed a retrospective, single-institutional cross-sectional analysis of all remote patient appointments from March 17, 2020eAugust 31, 2020. The primary outcome was appointment completion rate. Patients were determined to have not completed an appointment if they canceled, left before being seen or were a "no show." Secondary analysis evaluated factors associated with scheduling video vs telephone appointment. Various patient and appointment-specific factors were analyzed. Chi-squared tests and univariate logistic regression were used for analysis accordingly.Results: Of 3,769 appointments, 2,996 (79.5%) were completed while 773 (20.5%) were not, with 1,544 (41.0%) completed over telephone while 2,225 (59.0%) used video. Race, age, income, insurance, location, division and appointment length showed statistical significance (p <0.05) for appointment completion and visit modality. Females were more likely to use video (62.7% vs 58.0%, p¼0.01). Patients were more likely to complete afternoon visits (81.1% vs 78.3%, p¼0.04), visits with physicians (81.2% vs 75.4%, p <0.01) and phone calls (83.3% vs 76.9%, p <0.01).Conclusions: Multiple factors were associated with both appointment completion rate and use of telephone or video. These factors may reflect disparities in social determinants of health and select patients may benefit from additional coordination of care to prevent missed appointments and deconstruct inequities.
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