Abstract
BackgroundA long segment stricture in the anterior urethra is a challenge in urology. We conducted a study to investigate the efficacy of anterior urethral reconstruction using an everted saphenous vein graft (SVG) in a tubular fashion.MethodsTwelve male beagles were randomly divided into three groups: experimental group (n = 5), control group (n = 5) and normal group (n = 2). A 3 cm defect in the anterior urethra was created. Autologous SVG was harvested. In the experimental group, urethral defect was replaced by an everted SVG in a tubular fashion. In the control group, urethral reconstruction was performed using an uneverted SVG. Beagles in all groups received retrograde urethrography to evaluate urethral patency and were killed for histological examination 6 months after operation.ResultsFour beagles in the experimental group had no voiding difficulty and the other one could not void spontaneously. Retrograde urethrography showed the four beagles in experimental group had wide urethral lumens. Ether urethral stricture or fistula were detected in all animals in the control group. Histological analysis of the four beagles in the experimental group indicated the everted SVG completely integrated into the urethra. The reconstructed urethra contained a wide lumen and was completely covered by urothelium. The periurethral collagen and muscle fibers formed and were highly organized. Everted SVG showed a high ability of neovascularization. In the control group, the reconstructed segment showed a fibrotic urethral lumen where the urothelium was not intact. Only few new capillaries were formed.ConclusionsEverted SVG demonstrates for a promising strategy for potential urethral stricture repair.
Highlights
A long segment stricture in the anterior urethra is a challenge in urology
We previously performed urethroplasty in a rabbit model using everted saphenous vein graft (SVG) as an onlay graft and gained encouraging results [8]
Urethroplasty using everted SVG This experimental animal protocol was approved by the Animal Experimentation Ethics Committee of Wannan Medical College in accordance with the Guide for the Care and Use of Laboratory Animals
Summary
A long segment stricture in the anterior urethra is a challenge in urology. We conducted a study to investigate the efficacy of anterior urethral reconstruction using an everted saphenous vein graft (SVG) in a tubular fashion. Adult and pediatric disorders of the urethra including hypospadias, trauma, and stricture require substituted urethroplasty to preserve the function of the urinary tract. Reconstruction of the anterior urethra is one of the most challenging problems in urology [1]. The saphenous vein is commonly used as vascular substitute material. It is harvested, and its associated wound complications were not dramatic, including. We hypothesized that everting vein graft makes the outside vascular endothelium cling to periurethral tissue. The endothelium quickly attracts blood supply from the surrounding periurethral tissues including dartos. We compare differences in neovascularization between everted SVG and noneverted SVG
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