Seyam Raouf M, Mandourah Hammam M, Kattan Mohamed S, Al-Hussain Turki, Altaweel Waleed M, Kattan Said A
Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Department of Pathology, King Faisal Specialist Hospital and Reserch Center, Riyadh, Saudi Arabia.
Transl Androl Urol. 2023 Aug 31;12(8):1238-1249. doi: 10.21037/tau-23-229. Epub 2023 Aug 15.
A penile tunica defect may arise during surgery in patients with Peyronie's disease. Collagen fleece (TachoSil) has recently gained popularity in penile surgery to cover the tunica albuginea (TA) defect associated with clinical success. However, it is not known what the histological outcomes of these grafts are in the penis. We aimed to study the histopathology of the TachoSil graft in an experimental animal model for the regeneration of TA, inflammation, fibrosis, and the underlying cavernous tissue.
Six adult male Sprague Dawley rats were used. The penis was degloved through a circumferential subcoronal incision. A longitudinal 1 mm × 10 mm defect was created at the base of the lateral aspect of the penis. A TachoSil patch (Takeda, Japan) was applied to the defect. The penile skin covering was then restored. At 2 months, the rat penis was excised and examined with hematoxylin, eosin, and trichrome stains. We conducted a literature review of penile grafts in animals for comparison.
Rats weighed 369.2 gm (standard deviation: 31.5). At 2 months, all rats showed normal-looking penis with complete healing, no scaring, tethering, or gross inflammatory features. Histopathology of the patch site showed fibrosis, chronic inflammation, and foreign body giant cell reaction. There was no generation of a new TA, or new vascularity. No inflammatory or pathological reaction affected the underlying corpus cavernous tissue. One rat died on the 6 postoperative day. Postmortem showed massive multiorgan hemorrhage consistent with disseminated intravascular coagulopathy (DIC). Unlike some other reported grafts, there is no TA regeneration.
TachoSil patching of penile TA defect forms a distinctive barrier against inflammation, protecting the underlying corpus cavernosum. However, no regeneration of the tunica defect is observed at 2 months. DIC is a potential complication of systemic absorption of TachoSil.
佩罗尼氏病患者在手术过程中可能出现阴茎白膜缺损。胶原绒（速即纱）最近在阴茎手术中受到欢迎，用于覆盖与临床成功相关的白膜（TA）缺损。然而，尚不清楚这些移植物在阴茎中的组织学结果如何。我们旨在研究速即纱移植物在TA再生、炎症、纤维化及潜在海绵体组织的实验动物模型中的组织病理学。
使用6只成年雄性斯普拉格-道利大鼠。通过冠状下环形切口将阴茎脱套。在阴茎外侧基部制造一个1毫米×10毫米的纵向缺损。将一片速即纱（日本武田公司）应用于缺损处。然后恢复阴茎皮肤覆盖。2个月时，切除大鼠阴茎，用苏木精、伊红和三色染色进行检查。我们对动物阴茎移植物进行了文献综述以作比较。
大鼠体重369.2克（标准差：31.5）。2个月时，所有大鼠阴茎外观正常，愈合完全，无瘢痕、粘连或明显炎症特征。移植物部位的组织病理学显示有纤维化、慢性炎症和异物巨细胞反应。没有新的TA生成或新血管形成。没有炎症或病理反应影响潜在的海绵体组织。1只大鼠在术后第6天死亡。尸检显示大量多器官出血，符合弥散性血管内凝血（DIC）。与其他一些报道的移植物不同，没有TA再生。
速即纱修补阴茎TA缺损形成了一个独特的抗炎屏障，保护了潜在的海绵体。然而，2个月时未观察到白膜缺损的再生。DIC是速即纱全身吸收的潜在并发症。
