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Related Experiment Videos

Small intestinal submucosa as a urethral coverage layer.

D J Grossklaus1, S B Shappell, M C Adams

  • 1Division of Pediatric Urology and Department of Pathology, Vanderbilt Children's Hospital and Vanderbilt University Medical Center, Nashville, Tennessee, USA.

The Journal of Urology
|July 18, 2001
PubMed
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Porcine small intestinal submucosa (SIS) effectively covered urethral defects in rabbits, preventing fistulas. Histology showed normal healing without SIS presence, suggesting SIS may reduce urethrocutaneous fistula complications in hypospadias surgery.

Area of Science:

  • Biomaterials Science
  • Regenerative Medicine
  • Urology

Background:

  • Urethrocutaneous fistula is a common complication following hypospadias surgery.
  • Biocompatible materials offer expanded options for complex surgical cases.
  • Porcine small intestinal submucosa (SIS) is a promising biomaterial for tissue regeneration.

Purpose of the Study:

  • To evaluate porcine small intestinal submucosa (SIS) as a coverage layer for urethral surgery.
  • To assess the histological changes associated with SIS when used as a urethral coverage layer in a rabbit model.
  • To determine if SIS impacts urethral healing and fistula formation.

Main Methods:

  • Urethral surgery was performed on 16 rabbits, divided into four groups: sham, SIS patch placement, urethroplasty without patch, and urethroplasty with SIS patch.

Related Experiment Videos

  • Graft edges were marked with sutures for identification.
  • Animals were maintained for 6 weeks, followed by histological examination of the urethra.

    • Main Results:

    • Histological examination revealed a foreign body reaction at the SIS graft site, with infiltration of histiocytes, giant cells, and lymphocytes.
    • No residual SIS material was found in any sections.
    • Urethral mucosa healed normally in all cases, with no evidence of acute or chronic inflammation outside the graft site.
    • No urethrocutaneous fistulas were observed in rabbits that underwent urethroplasty with or without an SIS patch.

    Conclusions:

    • Porcine small intestinal submucosa (SIS) serves as an adequate coverage layer for urethral defects in a rabbit model.
    • SIS did not interfere with normal urethral mucosal healing, despite eliciting a localized inflammatory response.
    • SIS may potentially reduce the incidence of urethrocutaneous fistulas by providing an extra tissue layer between the urethra and skin.