IS there a Difference in Platelet-Rich Plasma Application Method and Frequency to Protect Against Urethra Stricture?
Urology Journal,
,
1 January 2020
,
Page 6100
https://doi.org/10.22037/uj.v16i7.6100
Abstract
Material-Method: Fifty rats were randomized into 5 groups, with 10 rats in each group. The urethras of all rats were traumatized with a pediatric urethrotome knife at 6 and 12 o’clock, except in the sham group. Group 1 was the sham group and had only urethral catheterization daily for 15 days, Group 2 was given 0.9% saline (physiologic saline [(UI+PS]) once a day after urethral injury (UI+ PS), Group 3 was injected with PRP submucosally after urethral injury, Group 4 was given PRP once a day as intraurethral instillation using a 22 Ga catheter sheath with urethral injury, and Group 5 was given PRP twice a day as intraurethral instillation using a 22 Ga catheter sheath with urethral injury.
Each administration of PRP was administered as 300 million platelets/150 microliters. On day 15, the penises of the rats were degloved to perform penectomy. Histopathologic evaluation was made for spongiofibrosis, inflammation, and congestion in vascular structures.
Results: When the sham group, UI+PS, UI+PRPx1, UI+PRPx2 and UI+PRPs groups are compared in total, there were significant differences identified for parameters other than edema. When the UI+PS, UI+PRPx1, UI+PRPx2 and UI+PRPs groups are compared, the UI+PS group was observed to have significantly more inflammation (mucosal inf. 2.42 ±0.53) and spongiofibrosis (2.42 ±0.53). All the PRP groups were identified to have significantly less mucosal inflammation (UI+PRPs 1±0, UI+PRPx1; 1.4±0.51, PRPx2; 1.33±0.5) and spongiofibrosis (UI+PRPs; 1.57±0.53, PRPx1; 1.2±0.42, PRPx2; 1.55±0.52). The group with lowest spongiofibrosis was seen to be the PRPx1 group.
Conclusion: This study showed that PRP significantly reduced mucosal inflammation and spongiofibrosis, independent of administration route, when applied to the urethra after urethral trauma
- Urethral Stricture
- PRP
- Urethral Fibrozis
- Urethral inflamation
How to Cite
References
McCammon KA, Zuckerman JM, Jordan GH. “Surgery of the penis and urethra.” In: Wein AJ, Kavoussi LR, Partin AW,Peters CA,eds.Campbell-Walsh Urology 11th ed. Philadelphia:Elsevier;2016;40:907–945.e4.
Das SK, Jana D, Ghosh B, et al. “A comparative study between the outcomes of visual internal urethrotomy for short segment anterior urethral strictures done under spinal anesthesia and local anesthesia.” Turk J Urol. 2019 Nov 1;45(6):431-436. doi: 10.5152/tud.2019.49354.
Palminteri, E. , Berdondini E, Verze P, et al. “Contemporary urethral stricture characteristics in the developed world.” Urology, 2013. 81: 191. https://www.ncbi.nlm.nih.gov/pubmed/23153951
Gül M, Altıntaş E, Kaynar M, et al. “The predictive value of platelet to lymphocyte and neutrophil to lymphocyte ratio in determining urethral stricture after transurethral resection of prostate.” Turk J Urol. 2017 Sep;43(3):325-329. doi: 10.5152/tud.2017.14478. Epub 2017 Jul 31.
Santucci R, Eisenberg L. “Urethrotomy has a much lower success rate than previously reported.” J Urol. 2010;183:1859–1862.
Hofer MD, Cheng EY, Bury MI, et al. “Analysis of primary urethral wound healing in the rat.” Urology. 2014Jul;84.246.e1. http://dx.doi. org/10,1016/j.urology.2014.04.012.
Kilinc MF, Doluoglu OG, Eser PE, et al. “Intraurethral Erythropoietin to Prevent Fibrosis and Improve Urethral Healing: An Experimental Study in a Rat Model.” Urology. 2019 Jan;123:297.e9-297.e14. doi: 10,1016/j.urology.2018.05.045. Epub 2018 Jul 20.
Massara M, Barillà D, De Caridi G, et al. “Application of autologous platelet-rich plasma to enhance wound healing after lower limb revascularization: A case series and literature review.”Semin Vasc Surg. 2015 Sep-Dec;28(3-4):195-200. doi: 10.1053/j.semvascsurg. 2016.01.002. Epub 2016 Jan 20
Nikolopoulos KI, Pergialiotis V, Perrea D, et al. “Restoration of the pubourethral ligament with platelet rich plasma for the treatment of stress urinary incontinence.”Med Hypotheses. 2016 May;90:29-31. doi: 10.1016/j.mehy.2016.02.019. Epub 2016 Mar 2.
Guinot A, Arnaud A, Azzis O, et al. “Preliminary experience with the use of an autologous platelet-rich fibrin membrane for urethroplasty coverage in distal hypospadias surgery.” J Pediatr Urol. 2014 Apr;10(2):300-5. doi: 10.1016/j.jpurol.2013.09.026. Epub 2013 Nov 13.
Dubey D. “The current role of direct vision internal urethrotomy and self-catheterization for anterior urethral strictures.” Indian J Urol. 2011 Jul;27(3):392-6. doi: 10.4103/0970-1591.85445.
Ferguson GG, Bullock TL, Anderson RE, et al. “Minimally invasive methods for bulbar urethral strictures: a survey of members of the American Urological Association.” Urology. 2011 Sep;78(3):701-6. doi: 10.1016/j.urology.2011.02.051. Epub 2011 Jul 18
Akyuz M, Sertkaya Z, Koca O, et al. “Adult urethral stricture: practice of Turkish urologists.” Int Braz J Urol. 2016 Mar-Apr;42(2):339-45. doi: 10.1590/S1677-5538.IBJU.2014.0672.
Greenwell TJ, Castle C, Andrich DE, et al. “Repeat urethrotomy and dilation for the treatment of urethral stricture are neither clinically effective nor cost-effective.” J Urol. 2004 Jul;172(1):275-7
Da-Silva EA, Sampaio FJ, Dornas MC, et al. “Extracellular matrix changes in urethral stricture disease.” J Urol. 2002 Aug;168(2):805-7.
Sahinkanat T, Ozkan KU, Ciralik H, et al. “Botulinum toxin-A to improve urethral wound healing: an experimental study in a rat model.” Urology. 2009;73:405-409
Hebert PW. “The treatment of urethral stricture: transurethral injection of triamcinolone.” J Urol. 1972 Nov;108(5):745-7
Chung JH, Kang DH, Choi HY, et al. “The effects of hyaluronic acid and carboxy methylcellulose in preventing recurrence of urethral stricture after endoscopic internal urethrotomy: a multicenter, randomizedcontrolled, single-blinded study.” J Endourol. 2013 Jun;27(6):756-62. doi: 10.1089/end.2012.0613.
Cole AT, Curtis GA, Gill WB, “The use of a hydrocortisone antibacterial urethral insert in the treatment of urethral strictures: a preliminary report.” J Urol. 1972;108:742-744.
Ibrahim Yardimci, Tolga Karakan, Berkan Resorlu, et al. “The Effect of Intraurethral Dexpanthenol on Healing and Fibrosis in Rats With Experimentally Induced Urethral Trauma” Urology. 2015 Jan;85(1):274.e9-13. doi: 10.1016/j.urology.2014.09.038
Ayyıldız A, Nuhoglu B, Gulerkaya B, et al. “Effect of intraurethral Mitomycin-C on healing and fibrosis in rats with experimentally induced urethral stricture.” Int J Urol. 2004;11:1122-1126.
Mazdak H, Meshki I, Ghassami F. “Effect of mitomycin C on anterior urethral stricture recurrence after internal urethrotomy.” Eur Urol. 2007 Apr;51(4):1089-92; discussion 1092. Epub 2006 Nov 27.
Shirazi M, Khezri A, Samani SM, et al. “Effect of intraurethral captopril gel on the recurrence of urethral stricture after direct vision internal urethrotomy: Phase II clinical trial.” Int J Urol. 2007 Mar;14(3):203-8.
Nagler A, Gofrit O, Ohana M, et al. “The effect of halofuginone, an inhibitor of collagen type-i synthesis, on urethral strictureformation: in vivo and in vitro study in a rat model.” J Urol. 2000 Nov;164(5):1776-80.
Tavukcu HH, Aytaç Ö, Atuğ F, et al. “Protective effect of platelet rich plasma on urethral injury model of male rats.” Neurourol Urodyn. 2018 Apr; 37(4): 1286-1293. doi: 10.1002/nau.23460. Epub 2017 Dec 11.
Wang K, Guan Y, Liu Y, et al. “Fibrin glue with autogenic bone marrow mesenchymal stem cells for urethral injury repair in rabbit model.” Tissue Eng Part A. 2012;18:2507–2517. http://dx.doi.org/ 10.1089/ten.TEA.2011.0359.Epub. 2012 Aug 30
Arnalich F, Rodriguez AE, Luque-Rio A, et al. “Solid Platelet Rich Plasma in Corneal Surgery.” Ophthalmol Ther. 2016 Jun;5(1):31-45. doi: 10.1007/s40123-016-0051-9. Epub 2016 May 14.
Mohammadi R, Mehrtash M, Hassani N, et al. “Effect of Platelet Rich Plasma Combined with Chitosan Biodegradable Film on Full-Thickness Wound Healing in Rat Model.” Bull Emerg Trauma. 2016 Jan;4(1):29-37.
- Abstract Viewed: 0 times
- Just Accepted/6100 Downloaded: 0 times