Rabbit urethral regeneration using small intestinal submucosa onlay grafts

Kropp, Bradley P.; Ludlow, John K.; Spicer, Donald; Rippy, Marian K.; Badylak, Stephen F.; Adams, Mark C.; Keating, Michael A.; Rink, Richard C.; Birhle, Richard; Thor, Karl B.

doi:10.1016/s0090-4295(98)00114-9

Cited by 188 publications

(99 citation statements)

References 16 publications

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“…Thus, a large number of techniques have been used in the attempt to restore the anatomy of the organ, aiming to achieve adequate micturition and, in the cases of male patients, to enable forward ejaculation with an adequate amount of spermatozoids (1-5,7). All techniques used to date have a high rate of complications and, when such patients undergo several procedures, which is quite usual, the use of flaps or grafts is almost always necessary (5)(6)(7)14,15).…”

Section: Discussionmentioning

confidence: 99%

“…Urethral reconstruction is frequently used in the treatment of both congenital and acquired anomalies (1)(2)(3)(4)(5)(6). When the urethra needs to be repaired or reconstructed, either partially or totally, different surgical approaches can be used such as anastomosis of the urethral stumps, flaps or grafts.…”

Section: Introductionmentioning

confidence: 99%

“…Although such techniques are still largely employed, in several occasions adverse effects such as fistulas, stenosis, infections, stone formation, graft contracture or diverticula formation may appear. In addition to morbidity at the donor site, there is tissue scarcity when such patients undergo a number of surgical interventions (1,2,(4)(5)(6)(7)(8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

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Integration of collagen matrices into the urethra when implanted as onlay graft

Sayeg¹,

Freitas-Filho²,

Waitzberg

et al. 2013

Int. braz j urol.

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Objective: To assess the integration of decellularized heterologous collagen matrices into the urethra, when implanted with no cells or when seeded with autologous smooth muscle cells. Materials and Methods: Eighteen New Zealand rabbits were randomly assigned to two groups: Group I (n = 9) -animals undergoing urethral segment resection with interposition of a patch of heterologous collagen matrix seeded with autologous smooth muscle cells; Group II (n = 9) -animals undergoing resection of a urethral segment with interposition of a decellularized heterologous collagen matrix patch. Two animals from each group were sacrificed on postoperative days seven, fourteen and twenty-eight; three animals from each group were sacrificed at the end of three postoperative months. At the end of the third month one animal from each group underwent urethroscopy for urethral integrity assessment and one animal from each group had its microcirculation image captured by a SDF device (Side-stream Dark Field -Microscan Analysis Software). One animal from each group in each euthanasia period underwent cystourethrography so as the urethra could be viewed at flow time. The matrices integration was assessed through histological examination using hematoxylin and eosin (H&E), Masson trichrome (MT), Picrosirius red and Von Willebrand staining. In a blind study with two pathologists all the slides were studied. Results: The matrices whether seeded or not with autologous muscle cells were able to restore the architecture of the urethra, but were eliminated from the first week on, before incorporation. Microcirculation of the neourethra, at the end of the third month, showed the same characteristics as a normal urethra in both groups of animals. Conclusion: Natural heterologous matrices implanted in the urethra as onlay graft were not incorporated into its walls but were able to fully restore the cell architecture of the organ, regardless of being seeded or not with autologous muscle cells.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Integration of collagen matrices into the urethra when implanted as onlay graft

Sayeg¹,

Freitas-Filho²,

Waitzberg

et al. 2013

Int. braz j urol.

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“…Likewise, Atala 5 observed no stenosis or signs of leakage urine at urethrography after surgery. Kropp,29 comparing SIS and preputial skin grafts, reported urethral diverticulum formation in 25% of patients treated with skin substitution resulting in more than 50% increase in the luminal area. However, none of the animals in the SIS group showed radiological changes of the urethra after 12 weeks of follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…The SIS proved to be able to promote regeneration of transitional epithelium of bladder and urethral smooth muscle in rabbits. 5,[28][29][30] According to Kropp,25 there is a clear difference in the response of the host tissue to the graft foreskin when compared with SIS, where the latter provided a scaffold to the regenerative and remodeling process resulting in a normal urethral epithelium. In our study, all histological parameters evaluated were similar in the different groups.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study Between Porcine Small Intestinal Submucosa and Buccal Mucosa in a Partial Urethra Substitution in Rabbits

Kawano

Fugita

Yamamoto

et al. 2012

Journal of Endourology

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Purpose: Several urethral conditions may require tissue substitution. One collagen-base biomaterial that recently emerged as an option is small intestinal submucosa (SIS). The aim of this study was to compare the results of SIS and buccal mucosa for urethral substitution in rabbits. Materials and Methods: Thirty-six North Folk male rabbits were randomized into three groups. In all animals, a 10 · 5 mm urethral segment was excised, and the urethral defect was repaired using a one-layer SIS patch (group I [GI]); four-layer SIS (group II [GII]); or buccal mucosa (group III [GIII]). Urethrography was performed preoperatively and after 12 weeks. After sacrifice, graft retraction was objectively measured using Scion Image Ò computer analysis and by calculation of ellipse area. The grade of fibrosis, inflammatory reaction, vascular/ epithelial regeneration, and collagen III/I ratio were analyzed by hematoxylin/eosin and Picrosirius red staining. Results: Urethrography confirmed a wide urethral caliber without any signs of strictures after surgery. Urethral fistulae was diagnosed in 8.3% of cases (1 animal each group). Average graft shrinkage was 55.2% in GI; 44.2% in GII; and 57.2% in GIII ( p < 0.05). The intensity of chronic inflammation, fibrosis, epithelium regeneration, and neovascularization was similar in all groups ( p > 0.05). Collagen III/I ratio was higher in GII (GI: 119.6; GII: 257.2 and GIII: 115.0); p < 0.01. Conclusions: The four-layer SIS is more advantageous than the one-layer SIS and buccal mucosa for urethral substitution in rabbits.

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Regenerative Medicine and Cell Therapy

Sadri‐Ardekani

Atala

2015

Stem‐Cell Nanoengineering

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Rabbit urethral regeneration using small intestinal submucosa onlay grafts

Cited by 188 publications

References 16 publications

Integration of collagen matrices into the urethra when implanted as onlay graft

Integration of collagen matrices into the urethra when implanted as onlay graft

Comparative Study Between Porcine Small Intestinal Submucosa and Buccal Mucosa in a Partial Urethra Substitution in Rabbits

Regenerative Medicine and Cell Therapy

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