Urethroplasty using a bovine pericardium graft: an experimental study using normal urethras from dogs

Abstract

The use of bovine pericardium as a urethral patch to substitute a ventral segment of canine urethras was studied. Healing, epithelial growth, urethral permeability, fistulas, and calcification were analyzed. Thirty male mongrel dogs of medium and large size underwent resection of a ventral segment of the medial urethra measuring 2.0 x 0.5 cm, which was replaced with a bovine pericardium graft, treated with buffered glutaraldehyde and preserved in formaldehyde. Two running sutures of polygalactin 5-0 were applied, one on each side of the patch. The corpus spongiosum was closed with uninterrupted suture and the skin with interrupted suture of polygalactin 5-0. Six months later, the animals were examined and sacrificed under anesthesia. Retrograde urethrograms showed that the urethral healing was complete in six of the 30 animals, without stenosis, fistulas or dilations. Microscopic examination showed complete epithelization of these six urethras. The remaining 24 animals presented urethrocutaneous fistulas without stenosis, demonstrated by urethral catheterism using a 10-Fr plastic catheter. These data show that a successful urethral reconstruction of the penile urethra was possible in only 20% of the operated animals. Infection and leakage may be the cause of the urethrocutaneous fistulas present in 80% of cases. Further studies are necessary to determine whether such fistulas are avoidable. If they are, the bovine pericardium may well be an option in the treatment of urethral lesions in dogs.

A comparison of free skin graft, fascia lata, alloderm, bovine pericardium and primary repair in urethrocutaneous fistulas without diversion: an experimental study

“…Although Lara et al [17] have reported a 20% success rate for a 6-month-long period, in our 3 weeks short-period study; all the histopathological findings were observed to be in favor of healing except in terms of urethrography, macroscopic observations and fibrosis. The near 100% success rate in our study may be due to the short period of the study and to the different type of animal used.…”

“…In the literature, urethral fistula repair with BP in the dog was carried out by Lara et al [17]. Although Lara et al [17] have reported a 20% success rate for a 6-month-long period, in our 3 weeks short-period study; all the histopathological findings were observed to be in favor of healing except in terms of urethrography, macroscopic observations and fibrosis.…”

Pericardium in Reconstructive Urologic Surgeries: A Systematic Review and Meta-Analysis

“…Seven hundred fifteen patients underwent surgical reconstruction using pericardial grafts and had completed follow-up evaluations; 8 of these patients were published as case reports [8,10,11,31,37,40,47,48]. In addition, urologic reconstructive surgeries using pericardial grafts were performed on 139 animals comprising 45 rats [27,[54][55][56], 57 dogs [52,53,57,58], 31 rabbits [24,25,51], and 6 pigs [23]. The characteristics, overall outcomes, and the quality of all studies are summarized in Tables 1 and 2.…”

“…Moreover, 1 of 5 (20%) dogs undergoing bladder reconstruction showed signs of urine leakage at the first week of the postoperative period, and there was a defect in the anastomosis part [57]. Moreover, treated BP grafts were used for the reconstruction of urethral defects in 30 dogs, during which 80% of the animals presented with urethrocutaneous fistulae without stenosis, and one dog with a successful procedure died of respiratory infections 4 months later [53].…”

“…There are scarce data regarding the use of the pericardial tissue in urethroplasty. Lara et al [53] used treated BP for urethroplasty in dogs and showed a high rate of failure (80%) caused by urethrocutaneous fistulae without stenosis. Six dogs with successful operations had complete epithelialization of the urethra on microscopic evaluation.…”