Abstract
Figures and Tables
Fig. 1
Preparation of bladder submucosa matrix (BSM). (A) Gross image of acellular BSM, characterized by a thin sheet structure, acellular composition, multidirectional tensile strength, and not chemically cross-linked. (B) Hematoxylin and eosin (H&E) staining of acellular BSM; confirmation of its acellularity and structure as a framework of collagen fibers. (C) Lyophilized acellular BSM sheet.
![jkms-30-301-g001](/upload/SynapseData/ArticleImage/0063jkms/jkms-30-301-g001.jpg)
Fig. 2
Process of nontransected ventral urethral stricture model generation and urethroplasty. (A) Urethral defect created by urethrectomy. (B) Embedded urethral tissue on the BSM with fibrin glue (shown below the magnified figure). (C) Prepared combined graft with BSM and autologous urethral tissue. (D) Completed onlay graft. Scale bar, 10 µm.
![jkms-30-301-g002](/upload/SynapseData/ArticleImage/0063jkms/jkms-30-301-g002.jpg)
Fig. 3
Width of the penile urethra. (A) Retrograde urethrography (representative images of week 12) shows complete tubularization of both grafted urethras similar to the control group throughout the study period. The stricture group shows stenosis. (B) Measured urethral diameter at 4, 8, and 12 weeks postoperatively. The letters on the top of the bars indicate significant differences at P < 0.05. P values were obtained with analysis of variance and Tukey's test. Ctrl, sham-operated; Stricture, simple urethrotomy; BSM, urethrotomy and onlay urethroplasty with an acellular BSM scaffold graft; BSM/tissue, urethrotomy and onlay urethroplasty with a graft composed of autologous urethral tissue and an acellular BSM scaffold. The different letters (a and b) on top of the bars show significant differences (P < 0.05).
![jkms-30-301-g003](/upload/SynapseData/ArticleImage/0063jkms/jkms-30-301-g003.jpg)
Fig. 4
Histologic, Masson's trichrome, and immunohistochemical analysis of harvested urethra. (A-D) Low-magnification images of H&E-stained sections (40 ×); both graft groups show thick circular smooth muscle and a similar area of the urethral lumen as observed in the control group. The stricture group shows loose muscular layers and narrow lumen. (E-H) High-magnification images of H&E-stained sections (200 ×); the BSM/tissue grafts show compressed columnar epithelium, newly formed capillaries, and abundant circular bundles of smooth muscle, similar to controls. BSM grafts show fibrosis-like morphology and a simple smooth muscle layer as observed in the stricture group. (I-L) BSM/tissue grafts reveal scattered, variably sized circular bundles of smooth muscle. BSM grafts show few muscle fibers, extensive collagen deposition, and keratinized squamous cell epithelium. (M-P) BSM/tissue grafts express stratified columnar urothelium and stratified squamous cells. BSM grafts have a thin and irregular urothelial layer (400 ×). Scale bar, 10 µm.
![jkms-30-301-g004](/upload/SynapseData/ArticleImage/0063jkms/jkms-30-301-g004.jpg)
Notes
This work was supported by Biomedical Research Institute grant, Kyungpook National University Hospital (2013).
Conceived and designed the experiments: Kim BS, Chun SY. Performed the experiments: Kwon SY, Park SI. Analyzed the data: Song PH. Drafting of the manuscript: Chun SY, Kim BS. Critical revision of the manuscript for important intellectual content: Yoo ES, Kim BW, Kwon TG, Kim HT. Statistical analysis: Yoo ES. Obtaining funding: Kim HT, Kwon TG. Administrative, technical, or material support: Yoo ES, Kim BW.