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Bioengineered corporal tissue for structural and functional restoration of the penis - PubMed

  • ️Fri Jan 01 2010

Bioengineered corporal tissue for structural and functional restoration of the penis

Kuo-Liang Chen et al. Proc Natl Acad Sci U S A. 2010.

Abstract

Various reconstructive procedures have been attempted to restore a cosmetically acceptable phallus that would allow normal reproductive, sexual, and urinary function in patients requiring penile reconstruction. However, these procedures are limited by a shortage of native penile tissue. We previously demonstrated that a short segment of the penile corporal body can be replaced using naturally derived collagen matrices with autologous cells. In the current study, we examined the feasibility of engineering the entire pendular penile corporal bodies in a rabbit model. Neocorpora were engineered from cavernosal collagen matrices seeded with autologous cells using a multistep static/dynamic procedure, and these were implanted to replace the excised corpora. The bioengineered corpora demonstrated structural and functional parameters similar to native tissue and male rabbits receiving the bilateral implants were able to successfully impregnate females. This study demonstrates that neocorpora can be engineered for total pendular penile corporal body replacement. This technology has considerable potential for patients requiring penile reconstruction.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1.
Fig. 1.

Isolation and culture of autologous cells for tissue engineering. (A) Overall study design. (B) Culture expanded endothelial cells (Left) show positive expression of cell specific marker von Willebrand factor protein (vWF), and smooth muscle cells show expression of smooth muscle specific a-actin (Right).

Fig. 2.
Fig. 2.

Cavernosometry and cavernosography. (A) Cavernosometry shows that all rabbits implanted with the bioengineered corpora after complete pendular penile corporal excision had sufficient intracorporal pressure (ICP) to attain erection (n = 12). The levels of ICP were comparable to native corpora (n = 12). (B) Cavernosography shows a homogenous appearance of corpora in the bioengineered group (n = 12), similar to the native corpora (n = 16), numerous filling defects in the unseeded control group (n = 12), and major filling gaps in the negative control group (n = 3).

Fig. 3.
Fig. 3.

Organ bath studies. (A) The response of corporal tissues to carbachol-induced relaxation at 3 months postimplantation. (B) A nitric oxide donor, sodium nitroprusside, can induce relaxation of the bioengineered corporal tissues as early as 1 month after implantation. (C) Tissue strips obtained from the bioengineered neo-corpora responded to phenylephrine administration as early as 1 month after implantation. The responses correlated with the concentration of phenylephrine. (D) The bioengineered grafts at 3 and 6 months showed strong contractile responses to electrical field stimulation (EFS) at 80 V with stimulation frequency of 32 Hertz. (P < 0.05; compared between experimental and control groups). n = 4–7 per time point. Key: Normal Cont: Normal Rabbits, Exp: Implants with Cells, Cont: Implants without Cells, Neg Cont: Excision without implants.

Fig. 4.
Fig. 4.

Histological assessment of bioengineered neocorpora. Tissue reorganization following implantation of bioengineered neocorpora was observed at 1 month. At 3 and 6 months, tissue from the bioengineered neocorpora grafts was similar to normal controls (A and B). Presence of vascular structures was evident as early as 1 month after implantation. Fluorescent PKH26-labeled EC within vascular structures was also observed (C). EC were positive for immunohistochemical stain with antibodies detecting vWF and SMC were positive for stain with antibodies against smooth muscle alpha-actin in vivo (D and E).

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