Division of Urology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
J Urol. 2011 Oct;186(4 Suppl):1631-7. doi: 10.1016/j.juro.2011.04.008.
We analyzed the histological and functional characteristics of the tubularized incised plate vs dorsal inlay graft urethroplasty in an experimental rabbit model.
A total of 24 New Zealand male rabbits were randomly allocated into 4 groups, including sham operation, urethroplasty, tubularized incised plate urethroplasty and dorsal inlay graft urethroplasty. In the urethroplasty group the anterior urethral wall was half excised and the dorsal aspect was tubularized. In the tubularized incised plate group the same steps were followed but tubularization followed a longitudinal midline incision in the dorsal wall. In the dorsal inlay graft group the defect created by the dorsal incision was covered with an inner preputial graft. The animals were sacrificed at 4 and 8 weeks, respectively. The penis was immediately harvested for standardized passive flowmetry and subsequently fixed for histological staining.
The grafts took in all animals. The tubularized incised plate defect was bridged by urothelium while in the dorsal inlay graft group the preputial graft kept its original histological characteristics. There was a significant decrease in average flow in the urethroplasty group (1.6 ml per second) compared to that in the sham operated group (3.4 ml per second) and to the other groups (p <0.05). However, no significant difference in average flow was found for the tubularized incised plate and dorsal inlay graft groups (2.4 and 2.2 ml per second, respectively, p = 0.7).
In this short-term rabbit model dorsal inlay graft urethroplasty was feasible with good graft take and integration. Simple tubularization of a reduced urethral plate led to significantly decreased flow. Incision of the reduced plate with or without grafting improved the average flow. Findings in this experimental model do not support the superiority of dorsal inlay graft urethroplasty over tubularized incised plate urethroplasty in terms of urethral flow dynamics.
我们分析了管状切开板与背侧镶嵌移植物尿道成形术在实验性兔模型中的组织学和功能特征。
24 只新西兰雄性兔随机分为 4 组，包括假手术组、尿道成形术组、管状切开板尿道成形术组和背侧镶嵌移植物尿道成形术组。在尿道成形术组中，前尿道壁被半切除，背侧被管状化。在管状切开板组中，采用相同的步骤，但在背侧壁的纵中线切开后进行管状化。在背侧镶嵌移植物组中，用内层包皮移植物覆盖背侧切口所造成的缺损。动物分别在 4 周和 8 周时处死。立即采集阴茎进行标准化的被动流量测量，然后固定进行组织学染色。
所有动物的移植物均被接受。管状切开板缺损由尿路上皮桥接，而在背侧镶嵌移植物组中，包皮移植物保持其原始的组织学特征。与假手术组（3.4 毫升/秒）和其他组相比，尿道成形术组的平均流量显著下降（1.6 毫升/秒）（p<0.05）。然而，管状切开板和背侧镶嵌移植物组之间的平均流量没有显著差异（分别为 2.4 和 2.2 毫升/秒，p=0.7）。
在这个短期兔模型中，背侧镶嵌移植物尿道成形术是可行的，移植物接受良好且整合良好。简单的尿道板缩小管化导致流量显著下降。切开缩小的板或不移植可改善平均流量。在这个实验模型中的发现不支持背侧镶嵌移植物尿道成形术在尿道流动力学方面优于管状切开板尿道成形术。
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