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Liquid buccal mucosa graft endoscopic urethroplasty: a validation animal study

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World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To validate a novel method of urethral stricture treatment using liquid buccal mucosal grafts (LBMG) to augment direct vision internal urethrotomy (DVIU) in an animal model.

Materials and methods

A rabbit stricture model was used to test this method. Strictures were induced in 26 rabbits using electroresection of urethral epithelium. The animals were randomized into two groups: Group-1, treated with DVIU and LBMG in fibrin glue, and Group-2, DVIU with fibrin glue only. LBMG was prepared by suspension of mechanically minced buccal mucosa micrografts in fibrin glue. This LBMG-fibrin glue mixture was later injected into the urethrotomies of Group-1 animals. All animals were killed at 24 weeks after repeat retrograde urethrogram (RUG) and urethroscopy by surgeon blinded to the treatment arm. Radiographic images and histological specimens were reviewed by a radiologist and a pathologist, respectively, blinded to the treatment arm. Stricture treatment was considered a success if a diameter measured on RUG increased by ≥ 50% compared to pre-treatment RUG diameter. Histological specimens were assessed for the presence of BMG engraftment.

Results

In Group-1, 8/12(67%) animals demonstrated engraftment of LBMG, compared to none in Group-2 (p = 0.0005). 7/12(58%) in Group-1 showed radiographic resolution/improvement of strictures compared to 5/13 Group-2 rabbits (38%, p = 0.145). The median percent change for the Group-1 was 59%, compared to 41.6% for Group-2 (p = 0.29).

Conclusion

This proof-of-concept study demonstrates feasibility of LBMG for endoscopic urethral stricture repairs. Further studies are needed to establish the role of this novel concept in treatment of urethral strictures.

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Acknowledgements

This study was supported by the Northeastern Section of the American Urological Association through a Young Investigator Award Grant, and by a matching grant awarded by the Department of Urology at SUNY Upstate Medical University. We would like to thank Jennifer Kieffer and Nicolle Comstock, Animal Laboratory Staff, provided laboratory animal care.

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Authors and Affiliations

  1. Department of Urology, State University of New York Upstate Medical University, Syracuse, NY, USA

    Kathryn A. Scott, Guanqun Li, Jared Manwaring, Daniela A. Nikolavsky, Gennady Bratslavsky, Leszek Kotula & Dmitriy Nikolavsky

  2. Department of Pathology, State University of New York Upstate Medical University, Syracuse, NY, USA

    Yelena Fudym & Tiffany Caza

  3. Department of Radiology, State University of New York Upstate Medical University, Syracuse, NY, USA

    Zain Badar & Nicole Taylor

Authors
  1. Kathryn A. Scott
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  4. Daniela A. Nikolavsky
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Contributions

KAS: project development, data collection, data analysis, manuscript writing, and manuscript editing. GL: project development, data collection, data analysis, manuscript writing, and manuscript editing. JM: protocol development, project development, data collection, manuscript writing, and manuscript editing. DAN: protocol development, data collection, and manuscript editing. YF: data collection and manuscript editing. TC: protocol development, data collection, and manuscript writing. ZB: data collection and manuscript editing. NT: protocol development, data collection, and manuscript editing. GB: protocol development, project development, data analysis, and manuscript editing. LK: data collection and manuscript editing. DN: protocol development, project development, data collection, data management, data analysis, manuscript writing, and manuscript editing.

Corresponding author

Correspondence to Dmitriy Nikolavsky.

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The authors declare that they have no conflicts of interest.

Ethical approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. All the procedures performed in studies involving animals were in accordance with the ethical standards of the institution or practice at which the studies were conducted.

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Scott, K.A., Li, G., Manwaring, J. et al. Liquid buccal mucosa graft endoscopic urethroplasty: a validation animal study. World J Urol 38, 2139–2145 (2020). https://doi.org/10.1007/s00345-019-02840-5

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  • DOI: https://doi.org/10.1007/s00345-019-02840-5

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