Penile conditions, such as Peyronie's disease or tumor resection may require surgical reconstruction of the tunica albuginea. Various materials have been proposed, as a biomaterial for tunica albuginea repair, however, little functional data are available. We examined the applicability and functional outcome of a collagen-based matrix derived from the bladder (acellular bladder matrix (ABM)), as a biomaterial for tunica repair. Biocompatibility testing was performed on the matrix, which included mitochondrial metabolic activity, cell viability and apoptosis. Approximately 50% of the dorsal penile tunica albuginea was replaced with the collagen-based matrix patch after surgical removal in 24 New Zealand White rabbits. Cavernosometry and cavernosography were performed. The animals were killed 1, 2 and 3 months after surgery for analyses. The matrix showed excellent biocompatibility. All animals implanted with the matrix survived without any noticeable untoward effects. There was no evidence of inflammation or infection at the time of retrieval. Cavernosometry of the implanted animals demonstrated normal intracavernosal pressures with visual erections. Cavernosography of the repaired corpora showed a normal anatomical configuration. Biomechanical analysis of the retrieved matrices demonstrated similar tensile strengths as native tunica. Histologically, there was only a minimal inflammatory response, which gradually decreased over time. These results show that ABM is biocompatible, durable and effective when used as a tunica substitute. The matrix may be useful as an off-the-shelf biomaterial for patients requiring tunica albuginea repair.
We have previously shown that penile corporal structures engineered using autologous cells are able to achieve erection, penetration, and ejaculation. However, fully functional corpora could not be engineered because of the limited cellular content present within the corporal tissue construct. In this study, we investigated whether a dynamic seeding approach would improve cellularity within the corporal tissue construct and thereby restore normal erectile function. Corporal cells were either statically or dynamically seeded on acellular corporal tissue matrices and maintained in a bioreactor system. After 48 h, the cell-matrix complexes were implanted subcutaneously in athymic mice and analyzed for cell attachment, survival, and distribution using histological and molecular techniques. Native tissues and matrices without cells served as controls. The seeded cells attached and proliferated within the sinusoidal walls of the matrices. After completing the seeding, the DNA and cellular content of the dynamically seeded matrices reached 71% of normal corpora, whereas the statically seeded matrices reached 39% of normal corpora. These findings were confirmed histologically, biochemically, and using scanning electron microscopy. This study demonstrates that dynamic cell attachment, using a bioreactor system, leads to the formation of morphologically and biochemically improved corporal tissue, which may be useful for penile reconstruction.
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