Souza Geovanne F, Calado Adriano A, Delcelo Rosana, Ortiz Valdemar, Macedo Antonio
Divisions of Urology, Federal University of Sao Paulo, UNIFESP, Sao Paulo, SP, Brazil.
Int Braz J Urol. 2008 May-Jun;34(3):345-51; discussion 351-4. doi: 10.1590/s1677-55382008000300012.
Buccal mucosa is a widely accepted tissue for urethroplasty. The exact healing and tissue integration process, mainly the histological characteristics of dorsal buccal mucosa graft urethroplasty when used dorsally to reconstruct the urethral plate has not previously been assessed, and thus we developed an experimental model to address this question.
In 12 New Zealand rabbits (weight 2.5 kg) we surgically created a dorsal penile urethral defect. A buccal mucosa graft was sutured to the corpora and tunica albuginea, and the ventral urethra anastomosed to this new urethral plate. The animals were divided in three groups and sacrificed 1, 3 and 6 weeks after surgery (groups 1, 2 and 3). A retrograde urethrogram was obtained at autopsy in the last group and the penis analyzed histologically with hematoxylin-eosin and Masson's staining.
The urethrograms showed no evidence of fistula or stricture. In group 1 the histopathological analysis showed submucosal lymph-mononuclear inflammatory edema, numerous eosinophils and squamous epithelium integrated into the adjacent urothelium. In group 2 there was no evidence of an inflammatory response but rather complete subepithelial hyaline healing, which was more marked in group 3.
Healing of buccal mucosa grafts to reconstruct the urethral plate can be achieved by total integration of the squamous epithelium with the urothelium, maintaining the original histological properties of the graft with no fibrosis or retraction.
颊黏膜是尿道成形术广泛采用的组织。背侧颊黏膜移植片用于重建尿道板时确切的愈合及组织整合过程，主要是其组织学特征，此前尚未得到评估，因此我们建立了一个实验模型来解决这个问题。
在12只新西兰兔（体重2.5千克）身上手术制造阴茎背侧尿道缺损。将颊黏膜移植片缝合于阴茎海绵体和白膜，腹侧尿道与这个新尿道板进行吻合。将动物分为三组，分别在术后1周、3周和6周处死（第1组、第2组和第3组）。最后一组在尸检时进行逆行尿道造影，并对阴茎进行苏木精-伊红染色和马松染色的组织学分析。
尿道造影未显示瘘管或狭窄迹象。第1组组织病理学分析显示黏膜下淋巴单核细胞炎性水肿、大量嗜酸性粒细胞以及鳞状上皮与相邻尿路上皮整合。第2组没有炎症反应迹象，而是完全的上皮下透明愈合，在第3组更为明显。
颊黏膜移植片重建尿道板的愈合可通过鳞状上皮与尿路上皮的完全整合实现，移植片保持其原始组织学特性，无纤维化或回缩。
