MP56-09 HISTOMORPHOLOGICAL ANALYSIS OF THE REGENERATIVE POTENTIAL OF PLATELET-RICH PLASMA DURING URETHROPLASTY (IN AN EXPERIMENTAL MODEL)

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) III (MP56)1 Sep 2021MP56-09 HISTOMORPHOLOGICAL ANALYSIS OF THE REGENERATIVE POTENTIAL OF PLATELET-RICH PLASMA DURING URETHROPLASTY (IN AN EXPERIMENTAL MODEL) Sergey Kotov, and Mikhail Iritsyan Sergey KotovSergey Kotov More articles by this author , and Mikhail IritsyanMikhail Iritsyan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002086.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Reconstructive plastic surgery is the gold standard for the treatment of primary urethral strictures, but the effectiveness of these methods does not reach 100%. In cases of recurrent urethral strictures, the effectiveness of standard operations is lower than in primary strictures, which requires the search for methods to improve the results of surgical treatment. To evaluate changes in the structure of the intercellular matrix, the cellular composition of the spongiose body, and the regenerative potential of platelet-rich plasma after urethroplasty on a biological model. METHODS: The experiment was performed on male rabbits of the breed "Burgundy" weighing 3.0-4.5 kg (18 individuals). Two groups of animals were formed: experimental (9 individuals) and control (9 individuals). All animals in each group underwent end-to-end anastomotic plasty of the bulbous urethra according to the standard procedure. In the control group, an isotonic solution of 0.9% NaCl was injected into the spongy body in the anastomosis zone; in the experimental group, autologous plasma enriched with platelets was administered. Routine hematoxylin-eosin staining was performed to visualize the histoarchitectonics of the tissues. Van Gieson staining to identify the collagen fibers and correct their orientation. In order to detail the inflammatory and regenerative changes, an additional immunohistochemical study was performed with antibodies: CD79a, CD43, CD31 (PECAM1), MMP1, MMP9. The expression level of MMP1, MMP9 was evaluated by counting positive cells in the submucosal and muscle layers. The level of angiogenesis in micro-preparations was estimated by counting the number of vessels, and reliable endothelial imaging was performed using CD31(PECAM1) expression. RESULTS: The local application of platelet-rich plasma in the suture zone contributes to a reduction in the zone of necrotic changes and the severity of inflammation, accelerated migration of macrophage-histiocyte cells to the focus of alteration, and increased blood supply due to enhanced angiogenesis. Also, in the experimental samples, there was a higher expression of metalloproteinases (collagenases) of type 1 and 9, reduced collagen production, and correct orientation of collagen fibers during the repair processes. CONCLUSIONS: According to the results of the experiment, the use of platelet-rich plasma promotes the acceleration of reparative processes in the spongy body after urethroplasty. In clinical practice, this may reduce the duration of lower urinary tract drainage and, consequently, the risk of infectious complications. In turn, the expression of metalloproteinases and a decrease in collagen production, the correct orientation of collagen fibers can reduce the amount of pathological fibrous-scar tissue in the surgical area, which reduces the risk of recurrence of urethral stricture after surgical treatment in clinical practice. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e972-e972 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sergey Kotov More articles by this author Mikhail Iritsyan More articles by this author Expand All Advertisement Loading ...