The preparation method of urethral extracellular matrix（ECM）was introduced and the biocompatibility of urethral ECM was studied.The urethral segmental defect was created artificially in animal models,which were foll...The preparation method of urethral extracellular matrix（ECM）was introduced and the biocompatibility of urethral ECM was studied.The urethral segmental defect was created artificially in animal models,which were followed by reconstruction with prepared urethral ECM.And postoperative histologic and pathologic exams were employed to evaluate the biocompatibility of urethral ECM.The experimental results show that urethral ECM was biocompatible and can promote cellular interaction as well as tissue development,Urethrography and urodynamic eraluation revealed that there was no difference between the normal and new tissue.The urethral ECM appears to be a useful material for urethral repair in the rabbit.It is biocompatible and for tissue handling.展开更多
Objectives:Pelvic fracture urethral injuries(PFUI)result from traumatic disruption of the urethra.A significant proportion of cases are complex rendering their management challenging.We described management strategies...Objectives:Pelvic fracture urethral injuries(PFUI)result from traumatic disruption of the urethra.A significant proportion of cases are complex rendering their management challenging.We described management strategies for eight different complex PFUI scenarios.Methods:Our centre is a tertiary referral centre for complex PFUI cases.We maintain a prospective database(1995e2016),which we retrospectively analysed.All patients with PFUI managed at our institute were included.Results:Over two decades 1062 cases of PFUI were managed at our institute(521 primary and 541 redo cases).Most redo cases were referred to us from other centres.Redo cases had up to five prior attempts at urethroplasty.We managed complex cases,which included bulbar ischemia,young boys and girls with PFUI,PFUI with double block,concomitant PFUI and iatrogenic anterior urethral strictures.Bulbar ischemia merits substitution urethroplasty,most commonly,using pedicled preputial tube.PFUI in young girls is usually associated with urethrovaginal fistula.Young boys with PFUI commonly have a long gap necessitating trans-abdominal approach.Our success rate with individualised management is 85.60%in primary cases,79.13%in redo cases and 82.40%in cases of bulbar ischemia.Conclusion:The definition of complex PFUI is ever expanding.The best chance of success is at the first attempt.Anastomotic urethroplasty for PFUI should be performed in experienced hands at high volume centres.展开更多
Background Urethral reconstruction for both congenital and acquired etiologies remains a challenge for most urologic surgeons Tissue engineering has been proposed as a strategy for urethral reconstruction The purpose ...Background Urethral reconstruction for both congenital and acquired etiologies remains a challenge for most urologic surgeons Tissue engineering has been proposed as a strategy for urethral reconstruction The purpose of this study was to determine whether a naturally derived extracellular matrix substitute developed for urethral reconstruction would be suitable for urethral repair in an animal model Methods A urethral segmental defect was created in 20 male rabbits The urethral extracellular matrix, obtained and processed from rabbit urethral tissue, was trimmed and transplanted to repair the urethral defect Then, the regenerated segment was studied histologically by haematoxylin eosin staining and Van Gieson staining at 10 days, 3 weeks, 6 weeks, and 24 weeks postoperation Retrograde urethrography was used to evaluate the function of the regenerated urethras of 4 rabbits 10 and 24 weeks after the operation The urodynamics of 4 rabbits from the experimental group and control group Ⅰ were assessed and compared In addition, 4 experimental group rabbits were examined by a urethroscope 24 weeks after the operation Results At 10 days after operation, epithelial cells had migrated from each side, and small vessels were observed in the extracellular matrix The matrix and adjacent areas of the host tissue were infiltrated with inflammatory cells The epithelium covered the extracellular matrix fully at 3 weeks postoperation Well formed smooth muscle cells were first confirmed after 6 weeks, at which point the inflammatory cells had disappeared At 24 weeks postoperation, the regenerated tissue was equivalent to the normal urethra Urethrography and urodynamic evaluations showed that there was no difference between normal tissue and regenerated tissue Conclusions Urethral extracellular matrix appears to be a useful material for urethral repair in rabbits The matrix can be processed easily and has good characteristics for tissue handling and urethral function展开更多
文摘The preparation method of urethral extracellular matrix（ECM）was introduced and the biocompatibility of urethral ECM was studied.The urethral segmental defect was created artificially in animal models,which were followed by reconstruction with prepared urethral ECM.And postoperative histologic and pathologic exams were employed to evaluate the biocompatibility of urethral ECM.The experimental results show that urethral ECM was biocompatible and can promote cellular interaction as well as tissue development,Urethrography and urodynamic eraluation revealed that there was no difference between the normal and new tissue.The urethral ECM appears to be a useful material for urethral repair in the rabbit.It is biocompatible and for tissue handling.
文摘Objectives:Pelvic fracture urethral injuries(PFUI)result from traumatic disruption of the urethra.A significant proportion of cases are complex rendering their management challenging.We described management strategies for eight different complex PFUI scenarios.Methods:Our centre is a tertiary referral centre for complex PFUI cases.We maintain a prospective database(1995e2016),which we retrospectively analysed.All patients with PFUI managed at our institute were included.Results:Over two decades 1062 cases of PFUI were managed at our institute(521 primary and 541 redo cases).Most redo cases were referred to us from other centres.Redo cases had up to five prior attempts at urethroplasty.We managed complex cases,which included bulbar ischemia,young boys and girls with PFUI,PFUI with double block,concomitant PFUI and iatrogenic anterior urethral strictures.Bulbar ischemia merits substitution urethroplasty,most commonly,using pedicled preputial tube.PFUI in young girls is usually associated with urethrovaginal fistula.Young boys with PFUI commonly have a long gap necessitating trans-abdominal approach.Our success rate with individualised management is 85.60%in primary cases,79.13%in redo cases and 82.40%in cases of bulbar ischemia.Conclusion:The definition of complex PFUI is ever expanding.The best chance of success is at the first attempt.Anastomotic urethroplasty for PFUI should be performed in experienced hands at high volume centres.
文摘Background Urethral reconstruction for both congenital and acquired etiologies remains a challenge for most urologic surgeons Tissue engineering has been proposed as a strategy for urethral reconstruction The purpose of this study was to determine whether a naturally derived extracellular matrix substitute developed for urethral reconstruction would be suitable for urethral repair in an animal model Methods A urethral segmental defect was created in 20 male rabbits The urethral extracellular matrix, obtained and processed from rabbit urethral tissue, was trimmed and transplanted to repair the urethral defect Then, the regenerated segment was studied histologically by haematoxylin eosin staining and Van Gieson staining at 10 days, 3 weeks, 6 weeks, and 24 weeks postoperation Retrograde urethrography was used to evaluate the function of the regenerated urethras of 4 rabbits 10 and 24 weeks after the operation The urodynamics of 4 rabbits from the experimental group and control group Ⅰ were assessed and compared In addition, 4 experimental group rabbits were examined by a urethroscope 24 weeks after the operation Results At 10 days after operation, epithelial cells had migrated from each side, and small vessels were observed in the extracellular matrix The matrix and adjacent areas of the host tissue were infiltrated with inflammatory cells The epithelium covered the extracellular matrix fully at 3 weeks postoperation Well formed smooth muscle cells were first confirmed after 6 weeks, at which point the inflammatory cells had disappeared At 24 weeks postoperation, the regenerated tissue was equivalent to the normal urethra Urethrography and urodynamic evaluations showed that there was no difference between normal tissue and regenerated tissue Conclusions Urethral extracellular matrix appears to be a useful material for urethral repair in rabbits The matrix can be processed easily and has good characteristics for tissue handling and urethral function
