Department of Urology, Federal University of São Paulo, São Paulo, Brazil.
BJU Int. 2011 Jul;108(2 Pt 2):E17-22. doi: 10.1111/j.1464-410X.2010.09708.x. Epub 2010 Nov 5.
To evaluate the use of tunica vaginalis as a dorsal free graft in the first stage of Bracka's urethroplasty in a rabbit animal model using macroscopic and histological analysis.
Surgery was performed on 16 rabbits, divided into four groups of four according to the number of weeks after surgery at which they were killed (2, 4, 8 and 12 weeks). The penile urethra was removed and only the ventral aspect of the urethra was reconstructed using a tunica vaginalis free graft dorsally fixed in the corpora cavernosa. Epithelial, inflammatory and fibrotic changes in the graft were evaluated macroscopically then histologically at the point when each rabbit group was killed.
Macroscopic evaluation showed good graft uptake with minimal retraction (P > 0.05). Histological evaluation showed a reduction in the inflammatory process during the first 4 weeks, after which inflammation stabilized. The mesothelium was partially healed at 2 and 8 weeks with a metaplasia defined by a stratified squamous, non-keratinized lining. The grafted area was thinner than the surrounding penile skin and similar to urothelial native epithelium.
Tunica vaginalis used as a free graft placed dorsally on the corpora cavernosa in the first stage of Bracka's urethroplasty shows good tissue integration and develops into a stratified non- keratinized epithelium (metaplasia) without significant retraction, despite exposure to the external environment.
通过宏观和组织学分析，评估在 Bracka 尿道成形术的第一阶段中，使用鞘膜作为背侧游离移植物的效果。
对 16 只兔子进行手术，根据手术后处死的周数（2、4、8 和 12 周）将其分为 4 组每组 4 只。切除阴茎尿道，仅使用背侧固定在海绵体上的鞘膜游离移植物重建尿道腹侧。在每个兔子组处死时，对移植物的上皮、炎症和纤维化变化进行宏观和组织学评估。
宏观评估显示移植物吸收良好，回缩最小（P > 0.05）。组织学评估显示，在最初的 4 周内炎症过程减少，之后炎症稳定。在 2 周和 8 周时，间皮部分愈合，表现为具有复层鳞状、非角化内衬的化生。移植物区域比周围阴茎皮肤薄，类似于尿路上皮固有上皮。
在 Bracka 尿道成形术的第一阶段中，将鞘膜作为背侧游离移植物置于海绵体上，显示出良好的组织整合，并发展成具有非角化复层上皮（化生），尽管暴露于外部环境，但无明显回缩。
