The effect of intraurethral dexpanthenol in hypospadias repair: experimental rabbit study

Abstract

In this study, the authors aimed to research the histopathologic effects of intraurethral use of dexpanthenol for hypospadias repair. Dexpanthenol is a derivative of pantothenic acid, a B complex vitamin. Pantothenic acid is a molecule contributing in the structure of coenzyme A. It decreases the release of myeloperoxidase from granulocytes and inhibits the formation of free oxygen radicals, and it exhibits an anti-inflammatory effect by increasing mitotic activity. The objective of this study is to evaluate the use of dexpanthenol after a tubularized incised plate urethroplasty (TIP) on wound healing, inflammation, and fibrosis. In this study, 18 healthy male New Zealand white rabbits weighing 2500-3000g were used. The 18 rabbits were randomly divided into 3 groups. For the hypospadias model, rabbits had a urethral catheter inserted in the urethra and a ventral midline incision was made from the glans tip to the central line of the penis. Afterward, the incision was closed with Vicryl (7/0) using the continuous suture technique, and urethroplasty was completed. For fourteen days, group I had 0.9% saline solution administered intraurethrally twice per day with a 22G catheter sleeve (control group), group II had one dose of 500mg/kg dexpanthenol (Bepanthene®; Bayer Turk Chemical Industry Limited Company, Turkey) ampoule and one dose of saline solution administered in the same way, and group III had two doses of 500mg/kg dexpanthenol ampoule administered. On the fifteenth day, the penis was degloved and rabbits had penectomy performed with samples sent to the pathology department for histopathological assessment. The degree of fibrosis and inflammation in group I (control group) was more severe than groups II and III. The differences between groups I and II were statistically significantly different for both fibrosis and inflammation (P=0.018 and P=0.041, respectively). The differences between groups I and III were also statistically significantly different for both fibrosis and inflammation (P=0.019 and P=0.011, respectively). Groups II and III were not different significantly for fibrosis and inflammation (P>0.05). This study shows that intraurethral dexpanthenol application has positive effects on fibrosis and inflammation. The main limitations of the study are that the hypospadias model was created surgically and long-term follow-up for fistula formation was not assessed. Administration of intraurethral dexpanthenol after hypospadias repair has positive effects on fibrosis and inflammation.