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Number №1, 2021 - page 19-25

Application of the cell-free matrix of the donor artery for plasty of posterior urethral strictures DOI: 10.29188/2222-8543-2021-14-1-19-25

For citation: Brumberg V.A., Astrelina T.A., Kazhera A.A., Kyzlasov P.S., Troyakov V.M., Malivanova T.F., Kobzeva I.V., Nikitina V.A., Karaseva T.V., Usupzhanova D.Yu., Brunchukov V.A., Rastorgueva A.A., Lishchuk S.V., Dubova E.A., Smolev D.M., Bashkov A.N., Samoilov A.S. Application of the cell-free matrix of the donor artery for plasty of posterior urethral strictures. Experimental and Clinical Urology 2021;14(1):19-25, https://doi.org/10.29188/2222-8543-2021-14-1-19-25
V.A. Brumberg, T.A. Astrelina, A.A. Kazhera, P.S. Kyzlasov, V.M. Troyakov, T.F. Malivanova, V.I. Kobzeva, V.A. Nikitina, T.V. Karaseva, D.Yu. Usupzhanova, V.A. Brunchkov, A.A. Rastorgueva, S.V. Lishchuk, E.A. Dubova, D.M. Smolev, A.N. Bashkov, A.S. Samoilov
Information about authors:
  • Brumberg V.A. – researcher at laboratory № 1 of the center for biomedical technologies of the A.I. Burnazyan state research center of the Federal STATE medical University of Russia; Moscow, Russia
  • Astrelina T.A. – Dr. Sc., associate Professor, head of the center for biomedical technologies of the A.I. Burnazyan state medical CENTER of the Russian Federation; Moscow, Russia; https://orcid.org/0000-0003-3629-0372
  • Kazhera A.A. – doctor of the Center of urology and andrology SSC FMBC of A.I. Burnazyan of FMBA of Russia; Moscow, Russia; https://orcid.org/0000-0002-4108-4066
  • Kyzlasov P.S.– Professor of Department of urology and andrology SSC FMBC of A.I. Burnazyan of FMBA of Russia, Dr.Sci. Med; Moscow, Russia; https://orcid.org/0000-0003-1050-6198
  • Troyakov V.M. – post-graduate student of the Department of urology and andrology SSC FMBC of A.I. Burnazyan of FMBA of Russia; Moscow, Russia
  • Kobzeva I.V. – PhD, head of Cryobank of the Center for biomedical technology, doctor of medical SSC, FMBC SSC center named after them. A. I. Burnazyan of FMBA of Russia; Moscow, Russia
  • Nikitina V.A. – PhD, senior researcher of laboratory №9 center of biomedical technology, SSC FMBC of A.I. Burnazyan of FMBA of Russia, a member of ISCT; Moscow, Russia; https://orcid.org/0000-0002-3150-7686
  • Karaseva T.V. – Head of the Department of biomedical technologies expertise and coordination of clinical research аt the center for biomedical technologies, FMBC of A.I. Burnazyan of FMBA of Russia; Moscow, Russia
  • Malivanova T.F. – PhD, senior researcher at the genome editing laboratory оf the center for biomedical technologies of the SSC FMBC of A.I. Burnazyan of FMBA of Russia; Moscow, Russia; https://orcid.org/0000-0001-9699-2603
  • Usupzhanova D.Yu. – Junior research associate of laboratory No.1 of the center for biomedical technologies of the SSC FMBC of A.I. Burnazyan of FMBA of Russia; Moscow, Russia 
  • Brunchkov V.A. – Junior researcher of the laboratory for genome editing of the biomedical technologies SSC FMBC of A.I. Burnazyan of FMBA of Russia; Moscow, Russia
  • Rastorgueva A.A. – Junior researcher of the laboratory for genome editing of the biomedical technologies SSC FMBC of A.I. Burnazyan of FMBA of Russia; Moscow, Russia
  • Lishchuk S.V. – pathologist, head of pathology Department, research SSC center named of A.I. Burnazyan of FMBA of Russia, PhD Med; Moscow, Russia; https://orcid.org/0000-0003-0372-5886
  • Dubova E.A. – Dr. Sc., doctor – pathologist of pathology Department of SSC FMBC of A.I. Burnazyan of FMBA of Russia; Moscow, Russia; https://orcid.org/0000-0002-7115-538X
  • Smolev D.M. – PhD, radiologist Department of radiation and radioisotope diagnostic of SSC FMBC of A.I. Burnazyan of FMBA of Russia; Moscow, Russia; https://orcid.org/0000-0002-9180-487
  • Bashkov A.N. – PhD, radiologist, head of Department of radiation and radioisotope diagnostic of SSC FMBC of A.I. Burnazyan of FMBA of Russia; Moscow, Russia; https://orcid.org/0000-0002-4560-6415
  • Samoilov A.S. – Dr. Sc., Prof. of RAS, the General Director of SSC FMBC of A.I. Burnazyan of FMBA of Russia; Moscow, Russia
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Introduction. Urethral stricture is a complex and urgent problem in operative urology. The main problem in the treatment of extended structures of the posterior urethra is the inability to form an adequate urethral site for augmentation urethroplasty with the common buccal graft, which has a priority in the treatment of penile strictures. The use of tissue acellular matrices may be promising in the development of reconstructive urology, which in the future will solve a number of problems associated with augmentation urethroplasty.

The purpose of this article is to study the possibility of using a cell-free matrix of a donor artery as a free flat flap for stricture replacement urethroplasty on a model of laboratory animals (rabbits).

Materials and methods. Donor blood vessels were Used, which were subjected to detergent-enzymatic perfusion decellularization. To assess the quality of the cell-free matrix, a histological study and an immunohistochemical study were performed. The cell-free flap of the donor artery was fixed to the protein envelope from the side of the simulated defect and posterior on-lay urethroplasty was performed.

Results and discussion. The resulting matrix was characterized by the absence of detectable cell nuclei, preserved type I collagen, and a DNA content of no more than 50 ng / mg of tissue. In the postoperative period, normal motor activity of animals, normal urination, weight loss was not observed. The levels of Creactive protein, creatinine, and urea in peripheral blood 5 months after surgery were within the normal range: 0.285±0.04839 mg / l, 93.5±8.057 mm / l, and 8.35±1.355 mm/l, respectively. If cystourethrography with the help of computer tomography data for stricture of the urethra is not revealed. During magnetic resonance imaging in the axial and sagittal projections, the patency of the urethra was indirectly confirmed.

Conclusion. In a laboratory animal model, it was shown that the resulting cell-free flap has in vivo biocompatibility and can be used for replacement urethroplasty of posterior urethral strictures.

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cell-free matrix; urethral stricture; replacement «op-lay» urethroplasty; computed tomography; magnetic resonance imaging.

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