Histological evaluation of an alternative method of neophalloplasty based on two lower abdominal skin flaps and simultaneous buccal mucosa graft in the ventral surface of the neophallus (two-stage urethroplasty): Experimental study in rabbits

Histological evaluation of an alternative method of neophalloplasty based on two lower abdominal skin flaps and simultaneous buccal mucosa graft in the ventral surface of the neophallus (two-stage urethroplasty): Experimental study in rabbits

Author Barbosa, Luiz Luna Autor UNIFESP Google Scholar
Ottoni, Sergio Leite Autor UNIFESP Google Scholar
Costa, Marnio Sollerman da Autor UNIFESP Google Scholar
Souza, Petrus Oliva de Autor UNIFESP Google Scholar
Venerando da Silva, Paulo Sergio Autor UNIFESP Google Scholar
Delcelo, Rosana Autor UNIFESP Google Scholar
Ortiz, Valdemar Autor UNIFESP Google Scholar
Castro, Roberto de Google Scholar
Macedo Junior, Antonio Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Osped Maggiore Bologna
Abstract Objective: To evaluate, in an experimental study in rabbits, a new model of neophalloplasty based on two lower abdominal skin flaps and ventral buccal mucosa graft for planned two-stage urethroplasty procedure.Material and methods: Sixteen rabbits were operated and divided into four equal groups which were sacrificed at 2, 4, 8 and 12 weeks. the inflammatory pattern, presence of sub-epithelial fibrosis and epithelial changes in the grafted area were evaluated histologically.Results: There were no deaths and no dehiscence of the wound was seen. One animal in the 2-week group developed an ulcer in the grafted area. We found minimal contracture of the neophallus, but this was not statistically significant between groups. Buccal mucosa graft showed good uptake in all groups, with vascular support from subcutaneous tissue of the flaps. the grafted area developed epithelial metaplasia, showing a decrease in cell layers with time, with disappearance of the sub-epithelial papillae and appearance of stratum granulosum and keratinization of the epithelial graft surface. A decrease in sub-epithelial fibrosis with replacement of immature by mature (eosinophilic) collagen was found. in the later groups was also observed an important decrease in inflammatory response, and the chorion of the grafted area presented a dilated capillary network, indicating that the process of neoangiogenesis was effective.Conclusion: Buccal mucosa displayed histological integration in the abdominal flaps with epithelial metaplasia in all groups. the surgical aspect of the neophallus was cosmetically acceptable, with minimal contracture. (C) 2008 Journal of Pediatric Urology Company. Published by Elsevier B.V. All rights reserved.
Keywords Penile agenesis
Urethroplasty
Buccal mucosa
Lower urinary traxt
Penis
Language English
Date 2009-06-01
Published in Journal of Pediatric Urology. Oxford: Elsevier B.V., v. 5, n. 3, p. 197-204, 2009.
ISSN 1477-5131 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 197-204
Origin http://dx.doi.org/10.1016/j.jpurol.2008.10.011
Access rights Closed access
Type Article
Web of Science ID WOS:000208054100009
URI http://repositorio.unifesp.br/handle/11600/31570

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