Lima Salvador Vilar Correia, Chagas Humberto Montoro, Monteiro Caio Cesar Paes, Ferraz-Carvalho Rafaela Siqueira, Albuquerque Amanda Vasconcelos, Silva Anderson Arnaldo, Lira Mariana Montenegro de Melo, Vilar Fábio Oliveira
Nucleus for Experimental Surgery, Post-graduate Program in Surgery, Department of Surgery, Health Sciences Center, Federal University of Pernambuco, Recife, Brazil.
Department of urology, Federal University of Alagoas, Maceio, Brazil.
Transl Androl Urol. 2021 Feb;10(2):841-850. doi: 10.21037/tau-20-1128.
Penile prostheses are the third option in the treatment of erectile dysfunction, however, despite their proven effectiveness, the occurrence of infections, advanced age of patients and comorbidities are the main limiting factors for this treatment modality. In the continuous search for biointegrated, clinically durable and minimally invasive treatment options, a possible model of penile prosthesis was sought through the use of intracavernous bacterial cellulose (BC) gel, in an experimental model of orchiectomized rabbits.
Thirty adult New Zealand rabbits were equally distributed into three groups: BC; vehicle and control. Each group was then subdivided according to the follow-up time of 3 and 6 months. Bilateral orchiectomy was performed 3 weeks before injection in the BC and vehicle groups. Pachymetry measurements of the penile axis, diameter and length were performed . Histomorphometry analyzes of the corpora cavernosa (CC), thickness of the tunica albuginea, cell density, collagen and elastic fibers post-injection were also performed, in addition to immunohistochemistry for newly formed vessels.
The implant of BC increased both the length and thickness of the penis three and six months after the last injection, with a consequent increase in the diameter of the CC. On the other hand, the filling effect was not observed in the control and vehicle groups, confirming the degradation of this tissue after orchiectomy and the effectiveness of BC as a filling agent. Histomorphometry analyzes corroborate the mass effect of BC integrated into the tissue, permeated by predominantly lymphomononuclear inflammatory infiltrate, multinucleated giant foreign body cells, fibroblasts, elastic fibers and newly formed vessels, without degradation or loss of volume, even after six months of implantation.
Biocompatibility and biointegration to the host tissue make BC a prosperous penile filling material, with local application and minimally invasive.
阴茎假体是治疗勃起功能障碍的第三种选择，然而，尽管其有效性已得到证实，但感染的发生、患者的高龄和合并症是这种治疗方式的主要限制因素。在不断寻求生物整合性好、临床耐用且微创的治疗选择过程中，通过在去势兔实验模型中使用海绵体内细菌纤维素（BC）凝胶，探索了一种可能的阴茎假体模型。
30只成年新西兰兔平均分为三组：BC组；赋形剂组和对照组。然后根据3个月和6个月的随访时间对每组进行细分。在BC组和赋形剂组注射前3周进行双侧去势。对阴茎轴、直径和长度进行测厚测量。除了对新形成血管进行免疫组织化学检测外，还对注射后海绵体（CC）进行组织形态计量学分析、白膜厚度、细胞密度、胶原和弹性纤维分析。
在最后一次注射后3个月和6个月，BC植入物增加了阴茎的长度和厚度，从而使CC直径增加。另一方面，在对照组和赋形剂组未观察到填充效果，证实了去势后该组织的降解以及BC作为填充剂的有效性。组织形态计量学分析证实了BC融入组织的质量效应，即使在植入6个月后，主要由淋巴细胞单核细胞炎性浸润、多核巨异物细胞、成纤维细胞、弹性纤维和新形成的血管渗透，且无降解或体积损失。
与宿主组织的生物相容性和生物整合性使BC成为一种有前景的阴茎填充材料，具有局部应用和微创性。
