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23-01-2012 | Surgery | Article

Stem cell-seeded grafts may improve surgical penis reconstruction


Free abstract

MedWire News: Adipose tissue-derived stem cells (ADSCs) may enhance the therapeutic effect of grafts used for surgical penis reconstruction, results of a study conducted in rats suggest.

The researchers found that rats undergoing tunica albuginea (TA) incision with autologous small intestinal submucosa (SIS)-ADSC grafts maintained better erectile function compared with animals grafted with SIS alone.

Writing in PNAS, Wayne Hellstrom (Tulane University Health Sciences Center, New Orleans, USA) and co-investigators explain that although cell-seeded acellular matrix grafts have been demonstrated to be effective for tissue reconstruction in other clinical settings, their therapeutic efficacy in procedures involving surgical intervention of the TA has not been investigated.

To address this, the researchers surgically implanted SIS and SIS-ADSC grafts into the penises of 16 rats (eight in each group). Eight weeks after implantation they evaluated the rats' erectile function.

The team observed significantly better erectile responses in rats with ADSC, versus non-ADSC, SIS grafts.

Compared with a sham group, rats with SIS-ADSC and SIS showed a 40% and 30% respective increase in mean penis diameter under flaccid and erectile states. This indicates that SIS has an "effective anticontractile effect," writes the team.

SIS grafting induced transcriptional upregulation of inducible nitric oxide synthase (NOS) and downregulation of endothelial NOS, neuronal NOS, and vascular endothelial growth factor. This effect was restored by seeding ADCSs on the SIS graft, say Hellstrom et al.

They explain that NO released from nitrergic nerves plays an important role in initiating trabecular smooth muscle relaxation and penile erection. "These findings suggest that ADSCs may produce an important restorative effect on constitutive NOS expression."

Of note, surgical penis reconstruction is often used to treat conditions, such as Peyronies disease, which is marked by the often-painful growth of plaques around the erectile tissues of the penis.

"The results of this study suggest that [the] SIS-ADSC approach may have potential clinical implications for grafting and reconstruction of the TA," concludes the team.

By Nikki Withers

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