Use of porcine small intestinal submucosa in bladder augmentation in rabbit: long-term histological outcome.

AIM: To investigate long-term histological features of bladder augmentation using porcine small intestine submucosa (SIS) in a rabbit model. MATERIALS AND METHOD: Sixteen New Zealand rabbits were used. Porcine SIS was provided by a manufactured formation derived from the pig. After partial cystectomy was carried out on the bladder, a single layer of SIS (Cook-SIS Technology, Cook Biotech Incorporated, West Lafayette, IN, USA) (2 x 5 cm) was sewn to bladder with continuous 5/0 vicryl suture material in a watertight manner. Urinary diversion was not used. The rabbits were killed 12 months later and perivesical fat was removed together with bladder. The 5-microm preparations taken from the samples were stained with haematoxylin-eosin and Mason's trichrome dye. S-100 and F8 stains were also used for immunohistochemical investigations. RESULTS: The macroscopic view of bladder was normal. SIS was indistinguishable from normal bladder wall, but the region of the graft had a slight white coloration. Microscopic observations showed the continuity of transitional epithelium of host bladder tissue on SIS material. Detrusor and serosal layers were formed and these layers were indistinguishable from host bladder. Fibroblasts were scattered among the collagen fibrils. New vessel formations were present without lymphatic proliferation. Nerve regeneration was excellent. No inflammation was observed in normal and regenerated bladder wall. CONCLUSION: At the end of 12 months, the long-term histological features of bladder augmentation with porcine SIS in a rabbit model, such as presence of new vessel formations, nerve regeneration, collagen and smooth muscle regenerations, which were indistinguishable from original bladder, and the absence of inflammation, showed that SIS seems to be a viable alternative to the use of intestine in bladder augmentation.

Effect of phospodiesterase 5 inhibitors on apoptosis and nitric oxide synthases in testis torsion: an experimental study.

To investigate the effects of phosphodiesterase (PDE) 5 inhibitors, sildenafil citrate and vardenafil HCl, on testicular germ cell apoptosis and also on the expressions of eNOS and iNOS within the bilateral testis after a unilateral torsion in a rat model. Forty-eight Wistar Albino rats, weighing between 210 and 262 g, were housed in individual cages. The rats were randomly assigned into four main groups and each group received drugs. Saline, sildenafil citrate and vardenafil HCl were given to each for 1 month and the last received no drug. After 1 month, testicular torsion was created for 1 h of ischemia and the left testis was untwisted and replaced to the scrotum for 2 h of reperfusion. At the end of 3 h, contralateral and ipsilateral testes were removed for histopathologic and biochemical examinations. Under light microscopy; the histopathological patterns of the contralateral testes in all groups were not affected. Mean apoptotic cell, eNOS and iNOS levels were increased in saline study group. The rats treated with vardenafil and sildenafil (groups 2s and 3s) showed significantly increased apoptotic cell, eNOS and iNOS values in ipsilateral testis (P < 0.05). Sildenafil citrate and vardenafil HCl caused an exaggerated testicular apoptosis after IR injury in rats. Additionally these drugs increased the NOSs levels in the testicular tissue.

Comparison of transurethral prostate resection and plasmakinetic prostate resection according to cautery artefacts in tissue specimens.

OBJECTIVES: The objectives were to evaluate cautery artifacts histopathologically in tissue specimens after plasmakinetic prostate resection (PKRP) and transurethral prostatectomy (TURP), and compare the results of the two procedures. MATERIALS AND METHODS: The histopathological specimens of 65 patients who underwent PKRP and TURP were examined retrospectively. Tissue chips for examination were selected randomly. Artifactual pathological patterns that were identified in the specimens included: abnormal cellular orientation and spindling, artifactual cellular detachment from the underlying basement membrane, atypical cytological changes and stromal coagulative necrosis. Each pattern identified was awarded 1 point. The severity of the cautery artefact was graded as absent, mild, moderate or severe according to the sum of points in each specimen. RESULTS: In TURP, the artefacts were graded absent (9%), mild (6%), moderate (18.7%), and severe (65.6%) changes. In PKRP, the artefacts were graded absent (6%), mild (18.1%), moderate (36.3%), and severe (39.4%) changes. While the number of mild and moderate artefacts observed was higher in PKRP (P = 0.023), severe artefacts were observed in higher numbers with TURP (P = 0.034). No prostate cancer was detected during the follow-up period. CONCLUSIONS: It has been observed that the application of TURP causes fewer mild to moderate artefacts and PKRP causes fewer severe artefacts in the histopathological evaluation of specimens in comparison to each other.

Intraurethral honey application for urethral injury: an experimental study.

OBJECTIVES: To evaluate the effect of honey applied intraurethrally after urethral injury on histopathological healing. MATERIALS AND METHODS: A total of Wistar male rats were used. The rats were divided into four groups: control (Group 1), sham (Group 2), 1 week honey applied group (Group 3) and 3 weeks honey applied group (Group 4). The urethral damage was caused with a 29 G needle. In sham group, only intraurethral saline solution was given, and 10% of honey was applied to rats in Groups 3 and 4 intraurethrally. After killing, penile tissues were investigated under a light microscopy. RESULTS: The irregularities of urethral epithelium and connective tissue were observed in Group 1. Also narrowing of lumen was present in control group rats except one rat in which no inflammation and total healing were observed. Hyperemia-bleeding was found in whole rats. In Group 2, there were irregularities in urethral epithelium and connective tissue. Total healing was observed in one rat. In Group 3, while regularity in urethral epithelium was present in six rats, inflammation and fibrosis was absent in rats. In Group 4, inflammation and fibrous tissue accumulation were not observed in rats. CONCLUSIONS: Intraurethral honey, applied after urethral injury, prevents inflammation, accelerates urethral healing and provides perfect healing.

A comparison of free skin graft, fascia lata, alloderm, bovine pericardium and primary repair in urethrocutaneous fistulas without diversion: an experimental study.

The purpose of this study is to compare primary repair procedure with those that use bio-concordant materials in the treatment of urethrocutaneous fistula. Twenty-five New Zealand rabbits were randomly placed into five groups (primary repair, free graft, allograft fascia lata, alloderm and bovine pericardium repair groups). A single dose of 20 mg/kg of ceftriaxon was applied intramuscularly as a prophylactic dose. Urethrocutaneous fistula was formed on midpenile level. Later, while primary repair was applied in one group, repair with free grafts and with other bio-concordant materials were performed in other groups. Urinary diversion was not used in any of the rabbits. The macroscopic observation was evaluated with urethrography obtained 21 days after the operation and then the rabbits were sacrificed. A total point was obtained by awarding a point to each good parameter in the histopathological evaluation and all the groups were compared. The urethrographic findings and macroscopic examinations were normal in all groups. In histopathological examinations, ranging from the best to worst results, bovine pericardium group (8 points) had a better total score than primary repair group (7 points), allograft fascia lata group (7 points) and alloderm group (7 points). The free graft group had the worst total point (6 points). Bio-concordant materials can be used in urethrocutaneous fistula repair as an alternative to primary repair or to the grafts obtained from body tissues.

Investigation of factors affecting result of distal hypospadias repair: comparison of two techniques.

OBJECTIVES: To evaluate the factors affecting the results, as well as the success of two techniques, by retrospectively investigating cases of distal hypospadias in which the patients had undergone Mathieu urethroplasty or tubularized incised plate urethroplasty. METHODS: We retrospectively evaluated 117 patients who underwent distal hypospadias repair. A percutaneous suprapubic catheter (Cistofix) and urethral split catheter were placed as a diversion in the 41 patients undergoing Mathieu urethroplasty. The Cistofix and urethral catheter were placed in 35 patients and a urethral catheter was placed in 41 of the patients who underwent tubularized incised plate urethroplasty. The success rates were compared according to the surgical technique, age, hypospadias status (primary or secondary), type of urinary diversion, and presence of chordee. RESULTS: No statistically significant difference in the success rate was found between the two techniques. Furthermore, the different types of diversion used in tubularized incised plate urethroplasty did not affect the success rate. When the success of primary hypospadias repair (n = 84) was compared with secondary hypospadias repair (n = 33), success in patients with secondary hypospadias was low. No difference was observed when operational success was compared in terms of patient age (older versus younger than 5 years of age) or the presence or absence of chordee. CONCLUSIONS: Our results have shown that tubularized incised plate urethroplasty should be preferred for distal hypospadias because of the better cosmetic results, invasive urinary diversions should be avoided, and the most importance should be given to the initial surgical intervention.