Leslie Bruno, Barboza Luiz L, Souza Petrus O, Silva Paulo S, Delcelo Rosana, Ortiz Valdemar, Macedo Antonio
Federal University of São Paulo, São Paulo, SP 04024-002, Brazil.
J Pediatr Urol. 2009 Apr;5(2):93-9. doi: 10.1016/j.jpurol.2008.09.003. Epub 2008 Nov 14.
To assess the use of tunica vaginalis graft plus onlay preputial island flap in urethral reconstructive surgery in rabbits through histopathology.
We developed an experimental model of urethroplasty that resembles one-stage complex hypospadias surgery with divided urethral plate. The tunica vaginalis graft is dorsally placed to recreate the urethral plate and the internal preputial island flap is placed onlay to complete the urethroplasty. Sixteen animals were divided into four equal groups and sacrificed at 2, 4, 8 and 12 weeks after surgery, the penis being sent for histopathological evaluation.
There were no deaths related to the procedure or wound breakdown; all rabbits voided spontaneously after surgery. Two urethrocutaneous fistulae were found. Microscopically, good tissue integration was observed, the tunica vaginalis mesothelium was gradually replaced by a more stratified epithelial lining, similar to the urothelial lining of the native urethra. The stratified squamous non-keratinized lining of the internal preputial island flap also changed into a thinner epithelial lining with only 4-5 cell layers. Two urethral diverticula were found.
A tunica vaginalis graft placed dorsally plus an onlay internal preputial island flap was shown to be a successful technique for urethroplasty in an animal model.
通过组织病理学评估兔尿道重建手术中使用睾丸鞘膜移植加覆盖岛状包皮瓣的效果。
我们建立了一种尿道成形术实验模型，类似于一期复杂性尿道下裂手术，尿道板分离。将睾丸鞘膜移植置于背侧以重建尿道板，将岛状包皮内瓣覆盖以完成尿道成形术。16只动物分为四组，每组数量相等，在术后2、4、8和12周处死，阴茎送去进行组织病理学评估。
无手术相关死亡或伤口裂开；所有兔子术后均能自主排尿。发现2例尿道皮肤瘘。显微镜下，观察到良好的组织整合，睾丸鞘膜间皮逐渐被更分层的上皮衬里取代，类似于天然尿道的尿路上皮衬里。岛状包皮内瓣的复层鳞状非角化衬里也变成了仅4-5层细胞的较薄上皮衬里。发现2例尿道憩室。
在动物模型中，背侧放置睾丸鞘膜移植加覆盖岛状包皮内瓣是一种成功的尿道成形术技术。
