Use of small intestinal submucosa for corporal body grafting in cases of severe penile curvature

Bradley P. Kropp*, Earl Y. Cheng, John C. Pope IV, John W. Brock, Martin A. Koyle, Peter D. Furness, Noel D. Weigel, Rick W. Keck, Kenneth A. Kropp

*Corresponding author for this work

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

Purpose: Small intestinal submucosa is a unique biomaterial that has been found to promote tissue specific regeneration in the urinary tract. We present our experimental and clinical experience with small intestinal submucosa (SurgiSis, Cook Biotech, Spencer, Indiana) for pediatric corporal body reconstruction. Material and Methods: A total of 20 Fischer rats underwent implantation of a 7 × 3 mm. small intestinal submucosa graft following excision of an ellipse of tunica albuginea and 14 control animals underwent tunical excision with reimplantation of this autologous segment. The animals were euthanized, and the penis was sectioned and histologically studied at intervals of 1, 2, 4, 6, 16 and 24 weeks. In 15 pediatric patients small intestinal submucosa was used for corporal body grafting. The grafting procedure was performed along the ventral (hypospadias cases) or dorsal (epispadias cases) surface of the corporal bodies. The tunica albuginea was incised full thickness at the point of maximal curvature down to the cavernosal tissue and the defect was filled with a single layer of small intestinal submucosa. Results: Measurements of the animal small intestinal submucosa grafts did not reveal significant graft contraction through 6 months. There was no graft expansion or ballooning after pharmacological induction of an artificial erection. Histologically, marked inflammation at 1 week precipitously decreased to a normal appearing tunica albuginea at 3 and 6 months. In all clinical cases small intestinal submucosa was found to be technically easy to handle. Mean followup is 14 months (range 5 to 26). All patients have a straight phallus as documented by observation of spontaneous erections or artificial erection at the time of stage 2 hypospadias repair. No complications occurred. Conclusions: Small intestinal submucosa demonstrates tissue specific regeneration properties in the rat and human tunica albuginea. It is an off-the-shelf material that is safe, technically easy to use and readily available.

Original languageEnglish (US)
Pages (from-to)1742-1745
Number of pages4
JournalJournal of Urology
Volume168
Issue number4 II
StatePublished - Oct 1 2002

Keywords

  • Hypospadias, tissue engineering
  • Transplants, penis

ASJC Scopus subject areas

  • Urology

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    Kropp, B. P., Cheng, E. Y., Pope IV, J. C., Brock, J. W., Koyle, M. A., Furness, P. D., Weigel, N. D., Keck, R. W., & Kropp, K. A. (2002). Use of small intestinal submucosa for corporal body grafting in cases of severe penile curvature. Journal of Urology, 168(4 II), 1742-1745.