Histologic Changes After Urethroplasty Using Small Intestinal Submucosa Unseeded With Cells in Rabbits With Injured Urethra

Villoldo, Gustavo; Loresi, Monica; Giúdice, Carlos; Moldes, Juan; Debadiola, Francisco; Barbich, Mariana; Argibay, Pablo

doi:10.1016/j.urology.2013.02.023

Cited by 14 publications

(10 citation statements)

References 25 publications

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“…Epithelial integrity was categorized as discontinuous or continuous, whereas epithelial structure was categorized as no structure, monolayered or layered, i.e., stratified structure. 23 Edema and the presence of inflammatory cells in the H&E-stained samples were evaluated to discover inflammation. Edema was scored from zero to three: 0 = none, 1 = mild, 2 = moderate and 3 = severe.…”

Section: Histologymentioning

confidence: 99%

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Comparison of Poly(l-lactide-co-ɛ-caprolactone) and Poly(trimethylene carbonate) Membranes for Urethral Regeneration: AnIn VitroandIn VivoStudy

Sartoneva

Nordback

Haimi

et al. 2018

Tissue Engineering Part A

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Urethral defects are normally reconstructed using a patient's own genital tissue; however, in severe cases, additional grafts are needed. We studied the suitability of poly(l-lactide-co-ɛ-caprolactone) (PLCL) and poly(trimethylene carbonate) (PTMC) membranes for urethral reconstruction in vivo. Further, the compatibility of the materials was evaluated in vitro with human urothelial cells (hUCs). The attachment and viability of hUCs and the expression of different urothelial cell markers (cytokeratin 7, 8, 19, and uroplakin Ia, Ib, and III) were studied after in vitro cell culture on PLCL and PTMC. For the in vivo study, 32 rabbits were divided into the PLCL (n = 15), PTMC (n = 15), and control or sham surgery (n = 2) groups. An oval urethral defect 1 × 2 cm in size was surgically excised and replaced with a PLCL or a PTMC membrane or urethral mucosa in sham surgery group. The rabbits were followed for 2, 4, and 16 weeks. After the follow-up, urethrography was performed to check the patency of the urethra. The defect area was excised for histological examination, where the epithelial integrity and structure, inflammation, and fibrosis were observed. There was no notable difference on hUCs attachment on PLCL and PTMC membranes after 1 day of cell seeding, further, the majority of hUCs were viable and maintained their urothelial phenotype on both biomaterials. Postoperatively, animals recovered well, and no severe strictures were discovered by urethrography. In histological examination, the urothelial integrity and structure developed toward a normal urothelium with only mild signs of fibrosis or inflammation. According to these results, PLCL and PTMC are both suitable for reconstructing urethral defects. There were no explicit differences between the PLCL and PTMC membranes. However, PTMC membranes were more flexible, easier to suture and shape, and developed significant epithelial integrity.

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Section: Histologymentioning

confidence: 99%

“…Edema was scored from zero to three: 0 = none, 1 = mild, 2 = moderate and 3 = severe. 23 Similarly, the presence of inflammatory cells was scored from zero to three. Normal inflammatory cell appearance was scored as zero; less than 25 % of all cells was scored as one; 25-50 % was scored as two and over 50 % was scored as three.…”

Section: Histologymentioning

confidence: 99%

Comparison of Poly(l-lactide-co-ɛ-caprolactone) and Poly(trimethylene carbonate) Membranes for Urethral Regeneration: AnIn VitroandIn VivoStudy

Sartoneva

Nordback

Haimi

et al. 2018

Tissue Engineering Part A

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“…Decellularized collagen-based biomaterials such as small intestinal submucosa (SIS) and bladder acellular matrix (BAM) have shown promise as acellular grafts for onlay urethroplasty. These matrices have been demonstrated to promote epithelial and smooth muscle tissue regeneration in short, semi-circumferential urethral defects by supporting host tissue integration in both animal models [23]–[25] as well as patients afflicted with hypospadias [26] and urethral strictures [27], [28]. Although initial defect consolidation is often achieved, long-term adverse side-effects such as stricture recurrence and fistula formation have been reported [29], [30], therefore raising the risk for graft failure and the need for surgical re-intervention.…”

Section: Introductionmentioning

confidence: 99%

Acellular Bi-Layer Silk Fibroin Scaffolds Support Tissue Regeneration in a Rabbit Model of Onlay Urethroplasty

Chung

Franck

et al. 2014

PLoS ONE

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Acellular scaffolds derived from Bombyx mori silk fibroin were investigated for their ability to support functional tissue regeneration in a rabbit model of urethra repair. A bi-layer silk fibroin matrix was fabricated by a solvent-casting/salt leaching process in combination with silk fibroin film casting to generate porous foams buttressed by homogeneous silk fibroin films. Ventral onlay urethroplasty was performed with silk fibroin grafts (Group 1, N = 4) (Width×Length, 1×2 cm2) in adult male rabbits for 3 m of implantation. Parallel control groups consisted of animals receiving small intestinal submucosa (SIS) implants (Group 2, N = 4) or urethrotomy alone (Group 3, N = 3). Animals in all groups exhibited 100% survival prior to scheduled euthanasia and achieved voluntary voiding following 7 d of initial catheterization. Retrograde urethrography of each implant group at 3 m post-op revealed wide urethral calibers and preservation of organ continuity similar to pre-operative and urethrotomy controls with no evidence of contrast extravasation, strictures, fistulas, or stone formation. Histological (hematoxylin and eosin and Masson's trichrome), immunohistochemical, and histomorphometric analyses demonstrated that both silk fibroin and SIS scaffolds promoted similar extents of smooth muscle and epithelial tissue regeneration throughout the original defect sites with prominent contractile protein (α-smooth muscle actin and SM22α) and cytokeratin expression, respectively. De novo innervation and vascularization were also evident in all regenerated tissues indicated by synaptophysin-positive neuronal cells and vessels lined with CD31 expressing endothelial cells. Following 3 m post-op, minimal acute inflammatory reactions were elicited by silk fibroin scaffolds characterized by the presence of eosinophil granulocytes while SIS matrices promoted chronic inflammatory responses indicated by mobilization of mononuclear cell infiltrates. The results of this study demonstrate that bi-layer silk fibroin scaffolds represent promising biomaterials for onlay urethroplasty, capable of promoting similar degrees of tissue regeneration in comparison to conventional SIS scaffolds, but with reduced immunogenicity.

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“…SIS, a xenogenic collagen matrix, was completely replaced by columnar epithelium and smooth muscle cells. 21,22 In preputial flaps the number of cell layers was noticeably decreased. 23 In tunica vaginalis grafts the mesothelial lining was replaced by stratified epithelium similar to native urothelium.…”

Section: Discussionmentioning

confidence: 98%

Histopathological Characteristics of Buccal Mucosa Transplants in Humans after Engraftment to the Urethra: A Prospective Study

et al. 2014

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Histologic Changes After Urethroplasty Using Small Intestinal Submucosa Unseeded With Cells in Rabbits With Injured Urethra

Cited by 14 publications

References 25 publications

Comparison of Poly(l-lactide-co-ɛ-caprolactone) and Poly(trimethylene carbonate) Membranes for Urethral Regeneration: AnIn VitroandIn VivoStudy

Comparison of Poly(l-lactide-co-ɛ-caprolactone) and Poly(trimethylene carbonate) Membranes for Urethral Regeneration: AnIn VitroandIn VivoStudy

Acellular Bi-Layer Silk Fibroin Scaffolds Support Tissue Regeneration in a Rabbit Model of Onlay Urethroplasty

Histopathological Characteristics of Buccal Mucosa Transplants in Humans after Engraftment to the Urethra: A Prospective Study

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