A morphometric analysis of bulbar urethral strictures
A morphometric analysis of bulbar urethral strictures
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DOI：
10.1111/j.1464-410x.2007.06904.x
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发表时间：
2007-08-01
影响因子：
4.5
通讯作者：
Sampaio, Francisco J. B.
中科院分区：
文献类型：
--
作者：
Cavalcanti, Andre G.;Costa, Waldemar S.;Sampaio, Francisco J. B.
目的对15例经尿道端端吻合术患者的尿道海绵组织标本进行定量和定性的组织学分析。用体视学方法对胶原含量、弹力纤维、平滑肌和血管进行分析。结果随着胶原的置换，管腔周围区的平滑肌、细胞外基质和血窦之间的关系完全丧失。创伤性狭窄患者纤维化区的扩展程度大于非创伤性狭窄患者。狭窄组和对照组外周海绵体区的平滑肌和胶原含量相似，创伤组和非创伤性组与耻骨上膀胱造瘘术前或未行耻骨上膀胱造瘘术前的结果相似。创伤组血管密度明显低于非创伤性组。术前耻骨上膀胱造瘘术前未行耻骨上膀胱造瘘术的患者，解放军中III型胶原含量增加，PS中I型胶原含量增加。与对照组相比，狭窄段的弹力纤维明显减少。结论尿道狭窄形成的特点是细胞外基质明显改变，从而导致器官功能的改变。
OBJECTIVES To report a quantitative and qualitative histological analysis of spongiosum tissue in patients with bulbar urethral strictures.MATERIALS AND METHODS Urethral specimens from 15 patients who had end-to-end anastomotic urethroplasty were evaluated; the control group comprised five bulbar urethras from cadavers. The collagen content, elastic fibres, smooth muscle and vessels were analysed using stereological methods.RESULTS There was complete loss of the relationship between smooth muscle, extracellular matrix and sinusoids in the peri-luminal area (PLA), with collagen replacement. The extension of the fibrotic area was greater in those with a traumatic than in those with an atraumatic stricture. The content of smooth muscle and collagen in the peripheral spongiosum (PS) area was similar for the stricture and control groups, and results were comparable for traumatic and atraumatic groups and those with suprapubic cystostomy diversion or not before surgery. There was a remarkably lower vascular density in the traumatic than in the atraumatic group. There was an increase in type III collagen in the PLA and in type I collagen in the PS; collagen type III in the PLA was greater in the group with no suprapubic cystostomy diversion before surgery. There were fewer elastic fibres in both stricture areas (PLA and PS) than in the control group.CONCLUSIONS Urethral stricture formation is characterized by marked changes in extracellular matrix features, with consequent changes in organ function.