Liu Xiao-He, Wang Ying, Liu Gang, Qin Jing-Li, Li Wei-Wei, Gao Dian-Jun
Weifang Medical University, Weifang, Shandong 261053, China.
Urological and Metabolic Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing 100144, China.
Zhonghua Nan Ke Xue. 2020 Apr;26(4):303-308.
To investigate the preventive effect of local injection of botulinum toxin type A (BTX-A) against iatrogenic anterior urethral stricture (IAUS) in New Zealand male rabbits.
Sixteen adult New Zealand male rabbits were randomly divided into an experimental and a control group of equal number. The model of IAUS was established in the rabbits by incision of the ventral urethra of the penile segment and electrocoagulation of the urethral mucosa. The rabbits of the experimental group were injected with 10 U of BTX-A solution and those of the control group with 1.0 ml of normal saline into the electrocoagulated submucosa of the urethra. At 30 days after modeling, retrograde urethrography was performed and the scarred urethral tissue harvested for HE and Masson staining.
No systemic symptoms of botulinum toxin poisoning were observed in either group of the rabbits. Retrograde urethrography showed statistically significant differences between the control and experimental groups in the diameter of the urethra ([0.15 ± 0.08] vs [0.50 ± 0.23] cm, P < 0.05) and the stenosis ratio (3.68 ± 1.22 vs 1.29 ± 0.15, P < 0.05). Urethrography revealed obvious hyperplasia and contracture of urethral scar with high bulge and narrow urethral cavity, while HE and Masson staining exhibited absence or discontinuity of the urethral epithelium, submucosal fibrosis with infiltration of a large number of fibroblasts, and hyperplasia and thickening of collagen fibers (blue) in the control group. All the changes above were slight and the urethral epithelium was continuous in the experimental group.
Local injection of BTX-A reduced the incidence of iatrogenic anterior urethral stricture after iatrogenic acute heat injury in New Zealand male rabbits.
探讨局部注射A型肉毒毒素(BTX-A)对新西兰雄性兔医源性前尿道狭窄(IAUS)的预防作用。
将16只成年新西兰雄性兔随机分为数量相等的实验组和对照组。通过切开阴茎段腹侧尿道并电凝尿道黏膜建立兔IAUS模型。实验组兔于尿道电凝黏膜下层注射10 U BTX-A溶液,对照组兔注射1.0 ml生理盐水。造模后30天,行逆行尿道造影,并取瘢痕尿道组织进行苏木精-伊红(HE)和马松(Masson)染色。
两组兔均未观察到肉毒毒素中毒的全身症状。逆行尿道造影显示,对照组和实验组在尿道直径([0.15±0.08]对[0.50±0.23]cm,P<0.05)和狭窄率(3.68±1.22对1.29±0.15,P<0.05)方面差异有统计学意义。尿道造影显示尿道瘢痕明显增生、挛缩,尿道腔高凸、狭窄,而对照组HE和Masson染色显示尿道上皮缺失或连续性中断,黏膜下纤维化伴大量成纤维细胞浸润,胶原纤维(蓝色)增生、增厚。实验组上述变化均轻微,尿道上皮连续。
局部注射BTX-A可降低新西兰雄性兔医源性急性热损伤后医源性前尿道狭窄的发生率。