Hu Yun-fei, Yang Si-xing, Wang Ling-long, Jin Hua-min, Zhan Bing-yan
Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China.
Zhonghua Zheng Xing Wai Ke Za Zhi. 2009 Jan;25(1):54-7.
To evaluate the feasibility of reconstruction of rabbit urethra using urethral extracellular matrix.
Extracellular matrix was obtained from the urethra of 20 donor New Zealand rabbits. In experimental group, 20 rabbits underwent segmental urethral resection (about 1.0 to 1.5 cm in length) and the defects were replaced by a tube of extracellular matrix. The serum TNFalpha was detected by ELISA to assess the immunity response preoperatively and 12, 24, 48 h postoperatively. The regenerated urethral segments were taken for histologic and pathologic study 10 days, 3 weeks, 6 weeks and 24 weeks after operation. The urodynamics, urethroscopy and urethrography were also performed.
The serum TNFalpha in experiment group slightly rised, with no significant difference when compared with that in control group. 10 days after operation, epithelial cell migrated into the extracellular matrix from two ends, and small vessels were also found. 3 weeks later, several layers of urothelium covered the whole surface of the matrix tube. 6 weeks later, the irregularly arranged smooth muscle fibers were fist observed by Van Gieson staining. 24 weeks after operation, the smooth muscle cells increased, the appearance of the regenerated urethra segments were very similar to normal urethral wall components. The urethrography and urodynamic evaluation revealed no difference between the normal and the regenerated urethral tube.
The urethral extracellular matrix might be an ideal replacement material for urethral defect.
评估使用尿道细胞外基质重建兔尿道的可行性。
从20只供体新西兰兔的尿道获取细胞外基质。实验组中，20只兔接受节段性尿道切除（长度约1.0至1.5厘米），缺损处用细胞外基质管替代。通过酶联免疫吸附测定法检测血清肿瘤坏死因子α，以评估术前及术后12、24、48小时的免疫反应。术后10天、3周、6周和24周取再生尿道节段进行组织学和病理学研究。还进行了尿动力学、尿道镜检查和尿道造影。
实验组血清肿瘤坏死因子α略有升高，与对照组相比无显著差异。术后10天，上皮细胞从两端迁移至细胞外基质，还发现了小血管。3周后，几层尿路上皮覆盖了基质管的整个表面。6周后，通过范吉森染色首次观察到排列不规则的平滑肌纤维。术后24周，平滑肌细胞增多，再生尿道节段的外观与正常尿道壁成分非常相似。尿道造影和尿动力学评估显示正常尿道管与再生尿道管之间无差异。
尿道细胞外基质可能是尿道缺损的理想替代材料。
