A Histomorphological Study of the Divergent Corpus Spongiosum Surrounding the Urethral Plate in Hypospadias

Bao, Xingqi; Huang, Yichen; Lyu, Yiqing; Xi, Zhengjun; Xie, Hua; Fu, Qiang; Song, Lujie; Chen, Fang

doi:10.1016/j.urology.2020.04.139

Cited by 9 publications

(9 citation statements)

References 17 publications

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“…Our previous histological study indicated disordered structure of vascular smooth muscle in corpus spongiosum of hypospadias (Bao et al, 2020), which is similar to the phenomenon in ED (Qinyu et al, 2021). Therefore, we speculated that phenotypic modulation of VSMCs may occur in the abnormality of corpus spongiosum in hypospadias and may be correlated to the aetiology of hypospaidas.…”

supporting

confidence: 70%

“…Samples were taken from the urethral corpus spongiosum on both sides of the forked urethral plate. The control group consisted of five patients with urethral stenosis caused by trauma (average age 15.8 years old), and the samples were healthy cavernosum tissue cut from urethral corpus spongiosum (Bao et al, 2020).…”

Section: Biopsy Samplesmentioning

confidence: 99%

“…Baskin et al (1998) and Van der Putte (2007) further described the histological abnormality of urethral spongiosum in hypospadias and found that the extensive vascularity of the spongiosum and glans were irregularly enlarged. Our previous study revealed that the abnormality in the urethral corpus spongiosum in hypospadias is the thickening of the vascular smooth muscle layer (Bao et al, 2020), suggesting the pathological changes of the vacular smooth muscle cells (VSMCs) may play an important role correalted to hypospadias.…”

Section: Introductionmentioning

confidence: 99%

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Phenotypic modulation of vascular smooth muscle cells in the corpus spongiosum surrounding the urethral plate in hypospadias

Huang

Shi

et al. 2022

Andrologia

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Hypospadias is an abnormal ventral development of the penis caused by incomplete virilization of the male genital tubercle. This study investigated the phenotypic modulation of vascular smooth muscle cells (VSMCs) in the corpus spongiosum surrounding the urethral plate in hypospadias. The urethral corpus spongiosum tissue was collected for HE, Masson and α‐SMA immunohistochemical staining. Spongiosum VSMCs were cultured and identified by α‐SMA fluorescence. qRT‐PCR and Western blotting and fluorescence were performed. The results showed that the vascular lumen of the corpus spongiosum around the urethral plate was larger and that the vascular smooth muscle layer was thicker in hypospadias. The expression of the contractile markers α‐SMA and Calponin 1 in VSMCs was decreased, the expression of the synthetic marker OPN was increased, and the transcription of the phenotypic switching factors SRF and MYOCD was decreased. The expression of Ki67, PCNA and BAX was increased, and the expression of Bcl‐2 was decreased. The phenotype of corpus spongiosum VSMCs in hypospadias changed from the contractional type to the synthetic type. This phenotypic modulation was associated with increased proliferation and apoptosis rates. SRF and MYOCD may be the main factors mediating the phenotypic modulation of urethral corpus spongiosum VSMCs.

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supporting

confidence: 70%

Section: Biopsy Samplesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Phenotypic modulation of vascular smooth muscle cells in the corpus spongiosum surrounding the urethral plate in hypospadias

Huang

Shi

et al. 2022

Andrologia

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“…The CS defect or fibrosis, usually accompanied by urethral defect, could be caused by congenital genitalia malformations (such as hypospadias), trauma, iatrogenic injury or infection (Bao et al, 2020;Mundy & Andrich, 2011).…”

Section: Discussionmentioning

confidence: 99%

Assessing the potential regeneration ability of corpus spongiosum in rabbit models

Wang

Peng

et al. 2020

Andrologia

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Corpus spongiosum (CS) is an important ingredient for the structural and functional integrity of the male spongy urethra (de Graaf et al., 2018). Both congenital and acquired urethral diseases can induce injury to CS. In patients with hypospadias or anterior urethral stricture, substitution urethroplasty using nonurethral tissues such as oral mucosa or penile skin flap is often performed to reconstruct urethra (Barbagli & Lazzeri, 2006). The fibrotic urethra and CS need to be removed before urethral reconstruction, inevitably leading to defect of the CS. Moreover, urethra reconstruction only reconstructs the urethral lumen, not the CS. The absence of CS could cause a decrease in the blood supply of the urethra and a lack of mechanical protection, which has negative impacts on reconstructed neo-urethra (Tonkin & Jordan, 2009). The main obstacle to successful repair of CS defect is the lack of suitable autologous tissues to serve as a substitute. However, patients with urethral defect usually have relatively healthy spongiosum tissue at the distal, proximal or dorsal side of the defective urethra. Enhancing regeneration or repair of CS defect may improve the long-term outcomes of substitution urethroplasty. But so far, only few tissue engineering or regenerative medicine strategies for promoting the regeneration of CS defect were reported (de Vocht et al., 2018). Acellular corporal spongiosum seeded with lingual keratinocytes and autologous corporal smooth muscle cells was used to repair urethral and CS defect (Feng et al., 2011). Histological

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“…Therefore, the occurrence of postoperative complications of hypospadias remains a great challenge for clinicians. Since the beginning of this century, many centers have promoted the use of the corpus spongiosum(11)(12)(13), along with the DF or tunica vaginalis fascia (TVF) as neourethral coverings in order to achieve improved results with urethral…”

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confidence: 99%

Using Buck's Fascia as an Integral Covering in Urethroplasty to Restore the Anatomical Structure of the Penis in One-Stage Hypospadias Repair: A Multicenter Chinese Study Comprising 1,386 Surgeries

et al. 2021

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Objectives: The objective of the study is to investigate the feasibility and efficacy of urethroplasty with a Buck's fascia integral-covering technique (BFIC) to wrap and restore the normal anatomical structure of the penis in one-stage hypospadias surgery.Methods: One-stage surgeries for hypospadias management were performed using BFIC from January 2016 to September 2020 at four high-volume medical centers in China. The technique integrates Buck's fascia with glans wings to mobilize and wrap the urethra and restore penile anatomical relationships. The clinical data, postoperative follow-up data, and complications were recorded, and the results were analyzed.Results: A total of 1,386 patients were included in the study: 1,260 cases of primary hypospadias and 126 cases of re-operations; distal in 382 cases (27.6%), mid-shaft in 639 (46.1%), proximal in 365 (26.3%); tubularized incised plate (TIP) in 748 cases, inlay-graft in 124, onlay-graft in 49, Mathieu in 28, free-tube graft urethroplasty in 406, and 31 of hybrid procedures. One thousand one hundred forty-two patients (82.4%) were found to have penile curvature (>10°) after artificial erection and all corrected by dorsal plication/s or transection of the urethra plate (UP) simultaneously. The median followed-up time was 27 months (6–62). A total of 143 (10.3%) complications were recorded: 114 (9.0%) in the primary operations and 29 (23%) in the re-operations, 15 (3.9%) in distal hypospadias, 61 (9.5%) in mid-shaft, and 67 (18.4%) in proximal. The complication rate in UP preservation and transection was 10.1 and 10.8%, respectively. Of all case complications, there were 73 (5.2%) of fistula, 10 (0.6%) of dehiscence, 22 (1.6%) of meatal stenosis, 21 (1.5%) of stricture, 6 (0.7%) of diverticulum, and resident curvature in 11 cases (1.2%). The overall complication rate in TIP and free-tube procedure was 9.8 and 9.9%, respectively, and fistula occurred in primary TIP of 33 cases (4.9%).Conclusions: Buck's fascia with the glans can be used as an integral covering technique in one-stage distal to proximal hypospadias and primary or re-operative hypospadias repair. It is safe, feasible, and effective for the repair of hypospadias.

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A Histomorphological Study of the Divergent Corpus Spongiosum Surrounding the Urethral Plate in Hypospadias

Cited by 9 publications

References 17 publications

Phenotypic modulation of vascular smooth muscle cells in the corpus spongiosum surrounding the urethral plate in hypospadias

Phenotypic modulation of vascular smooth muscle cells in the corpus spongiosum surrounding the urethral plate in hypospadias

Assessing the potential regeneration ability of corpus spongiosum in rabbit models

Using Buck's Fascia as an Integral Covering in Urethroplasty to Restore the Anatomical Structure of the Penis in One-Stage Hypospadias Repair: A Multicenter Chinese Study Comprising 1,386 Surgeries

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