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

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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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Sobre autores

Sergey Kotov

Pirogov Russian National Research Medical University; Moscow Multidisciplinary Clinical Center «Kommunarka» of the Moscow Department of Health; Pirogov City Clinical Hospital No. 1

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

Dr. Sc., Full Prof., Head of Urology and Andrology Department, Institution of Surgery

Rússia, 1, Ostrovityanov Street, Moscow, 117997; 108814, Moscow, pos. Sosenskoye, ul. Sosenskij stan, 8; 8 Leninsky Prospekt, Moscow, 119049

Nikita Sokolov

Pirogov Russian National Research Medical University; Moscow Multidisciplinary Clinical Center «Kommunarka» of the Moscow Department of Health

Autor responsável pela correspondência
Email: 4eaman@gmail.com
ORCID ID: 0000-0001-9091-8189

Postgraduate of Department of Urology and Andrology named after N.A. Lopatkin, Institution of Surgery; Urologist of Urology Division

Rússia, 1, Ostrovityanov Street, Moscow, 117997; 108814, Moscow, pos. Sosenskoye, ul. Sosenskij stan, 8

Anna Yapina

Pirogov Russian National Research Medical University

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

Student of Faculty of Medicine

Rússia, 1, Ostrovityanov Street, Moscow, 117997

Anvar Yusufov

Pirogov Russian National Research Medical University; Moscow Multidisciplinary Clinical Center «Kommunarka» of the Moscow Department of Health

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

PhD, Associate Professor of Urology and Andrology Department named after N.A. Lopatkin, Institution of Surgery; Head of Urology Division

Rússia, 1, Ostrovityanov Street, Moscow, 117997; 108814, Moscow, pos. Sosenskoye, ul. Sosenskij stan, 8

Svetlana Titkova

Pirogov Russian National Research Medical University

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

Senior Research Fellow, Experimental Surgery Department, Institution of Surgery

Rússia, 1, Ostrovityanov Street, Moscow, 117997

Ekaterina Klimenko

Pirogov City Clinical Hospital No. 1

Email: 4eaman@gmail.com

Pathologist, Department of Morbid Anatomy

Rússia, 8 Leninsky Prospekt, Moscow, 119049

Alexander Raksha

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

Email: 4eaman@gmail.com

Dr. Sc., Full Prof., Department of Clinical Pathological Anatomy; Head of Department of Morbid Anatomy, Institution of Human Biology and Pathology

Rússia, 1, Ostrovityanov Street, Moscow, 117997; 8 Leninsky Prospekt, Moscow, 119049

Mikhail Anurov

Pirogov Russian National Research Medical University

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

Dr. Sc., Head of Experimental Surgery Department, Institution of Surgery

Rússia, 1, Ostrovityanov Street, Moscow, 117997

Bibliografia

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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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