Comparative analysis of biomechanical properties of grafts and intact tunica albuginea in experiment

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Аннотация

Introduction. Existing treatment methods for Peyronie's disease (PD) aim to restore the normal biomechanical functions of the tunica albuginea (TA); however, current data on biomechanical changes in PD, as well as on the biomechanical properties of native human TA, are extremely limited. The aim of our study was to evaluate the biomechanical properties of intact TA and the materials most commonly used for its replacement.

Materials and Methods. Samples of the TA were collected from 9 male cadavers aged 20 to 65 years. Rectangular sections of the TA were excised from the dorsal surface of the corpora cavernosa. Fixation of the specimens in formalin was not performed, as this could affect the biomechanical properties of the tissue. Prepared samples were divided into longitudinal and transverse fragments. Pericardial grafts (allograft from cadaveric pericardium; xenograft from bovine pericardium) were prepared similarly. The obtained tissue fragments were subjected to mechanical testing. All tensile tests were conducted using a single-column universal material testing machine, the TA.XTplus Texture Analyzer (Stable Micro Systems Ltd., UK). Interactive stress-strain curves were used for result analysis. The following parameters were determined: stress, strength, strain, sample thickness. The obtained data were subjected to statistical analysis.

Results. Analysis of the obtained data revealed that the stress and strength of longitudinal fragments of TA were statistically significantly higher (p = 0,0004 and p = 0,0008; Tukey’s test) than those for the transverse fragments. This indicates that human TA is anisotropic. Correlation analysis showed a negative correlation between the patient age and the strength (r = –0,49; p < 0,05; Spearman’s rank correlation). Additionally, a negative correlation was found between the patient’s age and the thickness of their tunica albuginea (r = –0,56; p < 0,05 according to Spearman’s test). When comparing human TA with grafts from bovine and human pericardium, it was found that the strength and thickness calculated for human tunica albuginea were statistically significantly higher (p = 0,0001; Tukey’s test) than those for the grafts.

Conclusions. Human and bovine pericardium grafts significantly differ from healthy TA in terms of stress, elastic modulus, strength, and thickness, which may impact the outcomes of surgical treatment for patients with PD.

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Авторлар туралы

Sergey Kotov

Pirogov Russian National Research Medical University

Email: urokotov@mail.ru
ORCID iD: 0000-0003-3764-6131

Dr. Sc. (Med.), Professor, Head of the Lopatkin Urology and Andrology Department of the Institute of Surgery

Ресей, 1, Ostrovityanov St., Moscow, 117997

Nikita Sokolov

Pirogov Russian National Research Medical University; Kommunarka Moscow Multidisciplinary Clinical Center

Хат алмасуға жауапты Автор.
Email: 4eaman@gmail.com
ORCID iD: 0000-0001-9091-8189

Postgraduate Student of the Lopatkin Urology and Andrology Department of the Institute of Surgery; Urologist

Ресей, 1, Ostrovityanov St., Moscow, 117997; 8, Sosensky Stan St., Sosenskoe Village, Moscow, 108814

Anna Yapina

Pirogov Russian National Research Medical University

Email: yapina0@mail.ru
ORCID iD: 0009-0008-9092-4472

Student at the Faculty of Medicine

Ресей, 1, Ostrovityanov St., Moscow, 117997

Anvar Yusufov

Pirogov Russian National Research Medical University; Kommunarka Moscow Multidisciplinary Clinical Center

Email: anvar.yusufov@mail.ru
ORCID iD: 0000-0001-8202-3844

Cand. Sc. (Med.), Associate Professor at the Lopatkin Urology and Andrology Department of the Institute of Surgery; Head of the Urology Department

Ресей, 1, Ostrovityanov St., Moscow, 117997; 8, Sosensky Stan St., Sosenskoe Village, Moscow, 108814

Svetlana Titkova

Pirogov Russian National Research Medical University

Email: stitkova63@yandex.ru
ORCID iD: 0000-0001-5477-0084

Senior Researcher at the Experimental Surgery Department of the Institute of Surgery

Ресей, 1, Ostrovityanov St., Moscow, 117997

Ekaterina Klimenko

Pirogov City Clinical Hospital No. 1

Email: 4eaman@gmail.com

Pathologist at the Morbid Anatomy Department

Ресей, 8, Leninsky Ave., Moscow, 119049

Alexander Raksha

Pirogov Russian National Research Medical University; Pirogov City Clinical Hospital No. 1

Email: 4eaman@gmail.com

Dr. Sc. (Med.), Professor at the Department of Pathological Anatomy and Clinical Pathological Anatomy of the Institute of Human Biology and Pathology; Head of the Morbid Anatomy Department

Ресей, 1, Ostrovityanov St., Moscow, 117997; 8, Leninsky Ave., Moscow, 119049

Mikhail Anurov

Pirogov Russian National Research Medical University

Email: anurov@rsmu.ru
ORCID iD: 0000-0001-7512-2641

Dr. Sc. (Med.), Head of the Experimental Surgery Department of the Institute of Surgery

Ресей, 1, Ostrovityanov St., Moscow, 117997

Әдебиет тізімі

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2. Fig. 1. Schematic representation of the area of the white membrane collection, dissection, and preparation of fragments for mechanical testing

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3. Fig. 2. Microscopy of longitudinal sections of the tunica albuginea of the penis. Van Gieson staining

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4. Fig. 3. Microscopy of circular sections of the tunica albuginea of the penis. Van Gieson staining

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5. Fig. 4. View of the tunica albuginea of the penis after completion of dissection

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6. Fig. 5. Mechanical tensile test procedure

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7. Fig. 6. Diagrams showing the range of key mechanical indicators for the white shell

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8. Fig. 7. Diagrams showing the range of key mechanical indicators for the white membrane and graft made from bovine pericardium

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9. Fig. 8. Diagrams showing the range of key mechanical indicators for the white membrane and human pericardium graft

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10. Fig. 9. Fracture load-deformation curves obtained for the tested materials

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11. Fig. 10. Logistic regression graphs for discontinuous load-age (A) and thickness-age (B) for longitudinal fragments of the white membrane

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