Tunica Vaginalis

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Juan Chen - One of the best experts on this subject based on the ideXlab platform.

  • combined dorsal plus ventral double Tunica Vaginalis graft urethroplasty an experimental study in rabbits
    Urology, 2019
    Co-Authors: Xiaoliang Hua, Juan Chen
    Abstract:

    Abstract Objective To investigate the efficacy of a combined dorsal plus ventral double Tunica Vaginalis graft for urethral reconstruction in a rabbit model through radiology and histopathology. Methods Thirty adult male New Zealand rabbits were randomly divided into 6 groups as follows (n = 5): normal, stricture, and experimental groups A, B, C, and D. In the stricture and experimental groups, the ventral urethra was incised longitudinally, and the dorsal and ventral urethral mucosa were partially removed. Then, 3 × 20 mm and 5 × 20 mm Tunica Vaginalis grafts were obtained to repair the dorsal and ventral urethral mucosa defects, respectively, and the spongiosum was closed in the experimental groups. The urethral defects were not repaired in the stricture group. The rabbits in experimental groups A, B, C, and D were sacrificed at 2 weeks, 4 weeks, 12 weeks, and 24 weeks postoperatively, respectively, and the rabbits in the stricture group were sacrificed at 4 weeks postoperatively. The urethra was harvested for histological analysis. Urethrography was performed before sacrifice in the stricture group and experimental groups B and D. Results The retrograde urethrogram showed that all rabbits in experimental groups B and D had a patent urethra. Histological examination showed that the Tunica Vaginalis graft completely integrated into the urethra at 4 weeks postoperatively and transformed into a urinary pseudostratified epithelium at 12 weeks postoperatively. Conclusion Combined dorsal plus ventral double Tunica Vaginalis graft urethroplasty is a feasible technique for urethral reconstruction in a rabbit model.

Jonathan I Epstein - One of the best experts on this subject based on the ideXlab platform.

  • florid mesothelial hyperplasia of the Tunica Vaginalis mimicking malignant mesothelioma a clinicopathologic study of 12 cases
    The American Journal of Surgical Pathology, 2014
    Co-Authors: Stephen Lee, Peter B Illei, Jeong S Han, Jonathan I Epstein
    Abstract:

    The Tunica Vaginalis is an embryologically derived mesothelium-lined outpouching of the peritoneal cavity, which may develop neoplastic mesothelial proliferations similar to, although much less commonly than, pleural or peritoneal surfaces. We herein report our experience with 12 cases of florid par

  • mesothelioma of the Tunica Vaginalis a series of eight cases with uncertain malignant potential
    Modern Pathology, 2010
    Co-Authors: Fadi Brimo, Peter B Illei, Jonathan I Epstein
    Abstract:

    Well-differentiated papillary mesotheliomas have rarely been reported to involve the testis Tunica Vaginalis. While the classic histology of the originally described well-differentiated papillary mesotheliomas consisted of papillae lined by a single layer of bland cuboidal cells, more complex architectural patterns have been described. This report details our experience with eight paratesticular mesotheliomas that span the histological spectrum from classic well-differentiated papillary mesotheliomas to those with more complex patterns. We attempt to determine whether there are prognostic or immunohistochemical differences between these lesions and 28 diffuse malignant mesotheliomas. All cases had papillary/tubulopapillary in addition to more complex architectures (cribriform, condensed) and none showed evidence of invasion. Mitotic figures were present in seven cases and averaged 2.1 mitosis per 50 h.p.f. All cases showed ≤1% of positive cells staining for Ki-67 and p53, and only one case stained positive for GLUT-1 in comparison with 50% positivity for GLUT-1 in diffuse mesotheliomas. Of five patients with follow-up information of more than 1 year, three patients were alive at 2, 3 and 9 years, and two died of unknown causes at 5 and 47 years, suggesting that these lesions behave more indolently than typical malignant mesotheliomas of the Tunica Vaginalis. If these cases were diffuse malignant mesotheliomas, one would have expected at least some of the patients to have died of disease within a couple of years after diagnosis. However, detailed and long-term follow-up were not sufficiently available to reach definitive conclusions on the true biological behavior of these tumors. The morphological continuum noted between our cases and classic well-differentiated papillary mesotheliomas, combined with their immunohistochemical profile and indolent behavior, contrasts with that of diffuse malignant mesotheliomas. We propose that these Tunica Vaginalis mesotheliomas, which are more complex than the classic well-differentiated papillary mesotheliomas, and yet are not overtly histologically malignant, be classified as ‘mesotheliomas of uncertain malignant potential’.

Valdemar Ortiz - One of the best experts on this subject based on the ideXlab platform.

  • The Tunica Vaginalis Dorsal Graft Urethroplasty: Initial Experience
    2016
    Co-Authors: Roberto C Foinquinos, Adriano A Calado, Raimundo Janio, Adriana Griz, Antonio Macedo, Valdemar Ortiz
    Abstract:

    Introduction: Nowadays, buccal mucosa grafts are the most successful method to reconstruct bulbar urethral strictures. Dorsal placement of the graft has been recently proposed, allowing the graft to be spread fixed on the Tunica albuginea of the corporal bodies overlying the stricture. The dorsal graft is ingenious and represents a useful addition to the surgical armamentarium, since it offers a better chance for graft take than does the spongiosum when the urethra is diseased and poorly vascularized. We developed an additional reconstructive option using Tunica Vaginalis grafts, placed dorsally, fo

  • urethral duplication ii a y type with rectal urethra astra approach and Tunica Vaginalis flap for first stage repair
    International Braz J Urol, 2012
    Co-Authors: Antonio Macedo, Atila Rondon, Herick Bacelar, Sergio Leite Ottoni, Riberto Liguori, Gilmar Garrone, Valdemar Ortiz
    Abstract:

    INTRODUCTION: Urethral duplication is a rare congenital anomaly affecting mainly boys. Generally, the duplication develops on the sagittal plane; the accessory urethra may run dorsally or ventrally to the orthotopic one. We present a patient with urethral duplication in which the orthotopic urethra was patent in the penile segment but atresic in the bulbar and prostatic segment. The patient had urinary flow from the rectum and the ectopic urethra could be well identified by anal examination. MATERIALS AND METHODS: Age at surgery was 13 months. The procedure consisted of an ASTRA (anterior sagittal trans-ano-rectal) approach for dividing the urethra and rectum and was successful to move the urethra up to the perineal area. The rectum was reconstructed and the patient placed into a lithotomy position. A urethral catheter inserted in the penile urethra oriented us were the atresic urethra in bulbar area started. The scrotum was opened in the middle and the distance between the two urethral stumps proximal and distal defined the extension of no urethral tissue that consisted of 5 cm. We opened the right scrotal space and a Tunica Vaginalis flap was obtained and attached to the bulbar tissue for a two-stage urethroplasty strategy. RESULTS: Patient had a nice healing and the Tunica Vaginalis was nicely incorporated to the adjacent tissue, having the two urethral stumps well delineated. CONCLUSIONS: ASTRA approach in combination with a two-stage urethroplasty with Tunica Vaginalis dorsal flap proved to be an excellent combination for a rare case of urethral Y duplication having the main urethra into the rectum.

  • macroscopic and histological evaluation of Tunica Vaginalis dorsal grafting in the first stage of bracka s urethroplasty an experimental study in rabbits
    BJUI, 2011
    Co-Authors: Tiago Rosito, Valdemar Ortiz, Rosana Delcelo, Jesus Pires, Antonio Macedo
    Abstract:

    What’s known on the subject? and What does the study add? Complex urethral reconstruction done in two steps requires a dorsal component for the first procedure. Classically, preputial skin and buccal mucosa are used. We tested the Tunica Vaginalis for the same purpose. Tunica Vaginalis proved to be feasible as dorsal graft, histological properties showed metaplasia of the Tunica Vaginalis into an epithelium that resemble urothelium without clinically significant retraction. OBJECTIVE • To evaluate the use of Tunica Vaginalis as a dorsal free graft in the first stage of Bracka’s urethroplasty in a rabbit animal model using macroscopic and histological analysis. MATERIAL AND METHODS • Surgery was performed on 16 rabbits, divided into four groups of four according to the number of weeks after surgery at which they were killed (2, 4, 8 and 12 weeks). • The penile urethra was removed and only the ventral aspect of the urethra was reconstructed using a Tunica Vaginalis free graft dorsally fixed in the corpora cavernosa. • Epithelial, inflammatory and fibrotic changes in the graft were evaluated macroscopically then histologically at the point when each rabbit group was killed. RESULTS • Macroscopic evaluation showed good graft uptake with minimal retraction (P > 0.05). • Histological evaluation showed a reduction in the inflammatory process during the first 4 weeks, after which inflammation stabilized. • The mesothelium was partially healed at 2 and 8 weeks with a metaplasia defined by a stratified squamous, non-keratinized lining. The grafted area was thinner than the surrounding penile skin and similar to urothelial native epithelium. CONCLUSION • Tunica Vaginalis used as a free graft placed dorsally on the corpora cavernosa in the first stage of Bracka’s urethroplasty shows good tissue integration and develops into a stratified non- keratinized epithelium (metaplasia) without significant retraction, despite exposure to the external environment.

  • dorsal Tunica Vaginalis graft plus onlay preputial island flap urethroplasty experimental study in rabbits
    Journal of Pediatric Urology, 2009
    Co-Authors: Bruno Leslie, Rosana Delcelo, Valdemar Ortiz, Luiz L Barboza, Petrus Oliva De Souza, Paulo Sergio Lucas Da Silva, Antonio Macedo
    Abstract:

    Abstract Objective To assess the use of Tunica Vaginalis graft plus onlay preputial island flap in urethral reconstructive surgery in rabbits through histopathology. Material and methods We developed an experimental model of urethroplasty that resembles one-stage complex hypospadias surgery with divided urethral plate. The Tunica Vaginalis graft is dorsally placed to recreate the urethral plate and the internal preputial island flap is placed onlay to complete the urethroplasty. Sixteen animals were divided into four equal groups and sacrificed at 2, 4, 8 and 12 weeks after surgery, the penis being sent for histopathological evaluation. Results There were no deaths related to the procedure or wound breakdown; all rabbits voided spontaneously after surgery. Two urethrocutaneous fistulae were found. Microscopically, good tissue integration was observed, the Tunica Vaginalis mesothelium was gradually replaced by a more stratified epithelial lining, similar to the urothelial lining of the native urethra. The stratified squamous non-keratinized lining of the internal preputial island flap also changed into a thinner epithelial lining with only 4–5 cell layers. Two urethral diverticula were found. Conclusion A Tunica Vaginalis graft placed dorsally plus an onlay internal preputial island flap was shown to be a successful technique for urethroplasty in an animal model.

  • the Tunica Vaginalis dorsal graft urethroplasty experimental study in rabbits
    The Journal of Urology, 2005
    Co-Authors: Adriano A Calado, J Antonio R Macedo, Rosana Delcelo, Luiz Francisco Poli De Figueiredo, Valdemar Ortiz, Miguel Srougi
    Abstract:

    ABSTRACTPurpose: We created an experimental model of urethral defect and then repaired it using a Tunica Vaginalis graft applied on the dorsal surface of the urethra. We studied the histological and radiological characteristics of free Tunica Vaginalis graft urethroplasty.Materials and Methods: In 20 New Zealand rabbits a dorsal urethral defect was created by excising a portion of the dorsal urethral surface. The Tunica Vaginalis graft was placed dorsally over the corpora cavernosa and tied with 4 interrupted sutures. The mucosal margin of the urethral defect was sutured to the graft using 6–zero polydioxanone sutures in continuous fashion. The animals were divided into 4 equal groups and were sacrificed 14 days, and 4, 8 and 12 weeks after surgery, respectively. A retrograde urethrogram was done at autopsy. The penis was sent for histological analysis and an experienced pathologist evaluated the severity of acute and chronic inflammation, foreign body reaction and scar formation.Results: There were no de...

Antonio Macedo - One of the best experts on this subject based on the ideXlab platform.

  • The Tunica Vaginalis Dorsal Graft Urethroplasty: Initial Experience
    2016
    Co-Authors: Roberto C Foinquinos, Adriano A Calado, Raimundo Janio, Adriana Griz, Antonio Macedo, Valdemar Ortiz
    Abstract:

    Introduction: Nowadays, buccal mucosa grafts are the most successful method to reconstruct bulbar urethral strictures. Dorsal placement of the graft has been recently proposed, allowing the graft to be spread fixed on the Tunica albuginea of the corporal bodies overlying the stricture. The dorsal graft is ingenious and represents a useful addition to the surgical armamentarium, since it offers a better chance for graft take than does the spongiosum when the urethra is diseased and poorly vascularized. We developed an additional reconstructive option using Tunica Vaginalis grafts, placed dorsally, fo

  • urethral duplication ii a y type with rectal urethra astra approach and Tunica Vaginalis flap for first stage repair
    International Braz J Urol, 2012
    Co-Authors: Antonio Macedo, Atila Rondon, Herick Bacelar, Sergio Leite Ottoni, Riberto Liguori, Gilmar Garrone, Valdemar Ortiz
    Abstract:

    INTRODUCTION: Urethral duplication is a rare congenital anomaly affecting mainly boys. Generally, the duplication develops on the sagittal plane; the accessory urethra may run dorsally or ventrally to the orthotopic one. We present a patient with urethral duplication in which the orthotopic urethra was patent in the penile segment but atresic in the bulbar and prostatic segment. The patient had urinary flow from the rectum and the ectopic urethra could be well identified by anal examination. MATERIALS AND METHODS: Age at surgery was 13 months. The procedure consisted of an ASTRA (anterior sagittal trans-ano-rectal) approach for dividing the urethra and rectum and was successful to move the urethra up to the perineal area. The rectum was reconstructed and the patient placed into a lithotomy position. A urethral catheter inserted in the penile urethra oriented us were the atresic urethra in bulbar area started. The scrotum was opened in the middle and the distance between the two urethral stumps proximal and distal defined the extension of no urethral tissue that consisted of 5 cm. We opened the right scrotal space and a Tunica Vaginalis flap was obtained and attached to the bulbar tissue for a two-stage urethroplasty strategy. RESULTS: Patient had a nice healing and the Tunica Vaginalis was nicely incorporated to the adjacent tissue, having the two urethral stumps well delineated. CONCLUSIONS: ASTRA approach in combination with a two-stage urethroplasty with Tunica Vaginalis dorsal flap proved to be an excellent combination for a rare case of urethral Y duplication having the main urethra into the rectum.

  • macroscopic and histological evaluation of Tunica Vaginalis dorsal grafting in the first stage of bracka s urethroplasty an experimental study in rabbits
    BJUI, 2011
    Co-Authors: Tiago Rosito, Valdemar Ortiz, Rosana Delcelo, Jesus Pires, Antonio Macedo
    Abstract:

    What’s known on the subject? and What does the study add? Complex urethral reconstruction done in two steps requires a dorsal component for the first procedure. Classically, preputial skin and buccal mucosa are used. We tested the Tunica Vaginalis for the same purpose. Tunica Vaginalis proved to be feasible as dorsal graft, histological properties showed metaplasia of the Tunica Vaginalis into an epithelium that resemble urothelium without clinically significant retraction. OBJECTIVE • To evaluate the use of Tunica Vaginalis as a dorsal free graft in the first stage of Bracka’s urethroplasty in a rabbit animal model using macroscopic and histological analysis. MATERIAL AND METHODS • Surgery was performed on 16 rabbits, divided into four groups of four according to the number of weeks after surgery at which they were killed (2, 4, 8 and 12 weeks). • The penile urethra was removed and only the ventral aspect of the urethra was reconstructed using a Tunica Vaginalis free graft dorsally fixed in the corpora cavernosa. • Epithelial, inflammatory and fibrotic changes in the graft were evaluated macroscopically then histologically at the point when each rabbit group was killed. RESULTS • Macroscopic evaluation showed good graft uptake with minimal retraction (P > 0.05). • Histological evaluation showed a reduction in the inflammatory process during the first 4 weeks, after which inflammation stabilized. • The mesothelium was partially healed at 2 and 8 weeks with a metaplasia defined by a stratified squamous, non-keratinized lining. The grafted area was thinner than the surrounding penile skin and similar to urothelial native epithelium. CONCLUSION • Tunica Vaginalis used as a free graft placed dorsally on the corpora cavernosa in the first stage of Bracka’s urethroplasty shows good tissue integration and develops into a stratified non- keratinized epithelium (metaplasia) without significant retraction, despite exposure to the external environment.

  • dorsal Tunica Vaginalis graft plus onlay preputial island flap urethroplasty experimental study in rabbits
    Journal of Pediatric Urology, 2009
    Co-Authors: Bruno Leslie, Rosana Delcelo, Valdemar Ortiz, Luiz L Barboza, Petrus Oliva De Souza, Paulo Sergio Lucas Da Silva, Antonio Macedo
    Abstract:

    Abstract Objective To assess the use of Tunica Vaginalis graft plus onlay preputial island flap in urethral reconstructive surgery in rabbits through histopathology. Material and methods We developed an experimental model of urethroplasty that resembles one-stage complex hypospadias surgery with divided urethral plate. The Tunica Vaginalis graft is dorsally placed to recreate the urethral plate and the internal preputial island flap is placed onlay to complete the urethroplasty. Sixteen animals were divided into four equal groups and sacrificed at 2, 4, 8 and 12 weeks after surgery, the penis being sent for histopathological evaluation. Results There were no deaths related to the procedure or wound breakdown; all rabbits voided spontaneously after surgery. Two urethrocutaneous fistulae were found. Microscopically, good tissue integration was observed, the Tunica Vaginalis mesothelium was gradually replaced by a more stratified epithelial lining, similar to the urothelial lining of the native urethra. The stratified squamous non-keratinized lining of the internal preputial island flap also changed into a thinner epithelial lining with only 4–5 cell layers. Two urethral diverticula were found. Conclusion A Tunica Vaginalis graft placed dorsally plus an onlay internal preputial island flap was shown to be a successful technique for urethroplasty in an animal model.

  • the Tunica Vaginalis dorsal graft urethroplasty initial experience
    International Braz J Urol, 2007
    Co-Authors: Roberto C Foinquinos, Adriano A Calado, Raimundo Janio, Adriana Griz, Antonio Macedo
    Abstract:

    INTRODUCTION: Nowadays, buccal mucosa grafts are the most successful method to reconstruct bulbar urethral strictures. Dorsal placement of the graft has been recently proposed, allowing the graft to be spread fixed on the Tunica albuginea of the corporal bodies overlying the stricture. The dorsal graft is ingenious and represents a useful addition to the surgical armamentarium, since it offers a better chance for graft take than does the spongiosum when the urethra is diseased and poorly vascularized. We developed an additional reconstructive option using Tunica Vaginalis grafts, placed dorsally, for the treatment of anterior urethral strictures. SURGICAL TECHNIQUE: A total of 11 patients with anterior urethral strictures were treated with a Tunica Vaginalis graft urethroplasty. The surgical technique was done as described by Barbagli. The urethra was dissected from the corpora cavernosa and rotated 180 degrees. The dorsal urethral surface was exposed and fully opened. Both the distal and proximal lumina were calibrated. The Tunica Vaginalis graft was sutured, splayed and quilted over the corpora cavernosa using 6-0 PDS running stitches. The left side of the urethral mucosa was sutured to the graft using 6-0 PDS sutures. A 18F silicone Foley catheter was inserted at this point. The urethra was rotated back to its original position and sutured laterally to the right side of the graft. At the end of the procedure, the graft was completely covered by the urethra. With a follow-up ranging from 7 weeks to 5 months, all patients were voiding well (uroflowmetry > 14 mL per second). CONCLUSION: This initial experience in 11 patients indicates that Tunica Vaginalis dorsal graft urethroplasty may be considered within the reconstructive armamentarium of genitourinary surgeons.

Adriano A Calado - One of the best experts on this subject based on the ideXlab platform.

  • The Tunica Vaginalis Dorsal Graft Urethroplasty: Initial Experience
    2016
    Co-Authors: Roberto C Foinquinos, Adriano A Calado, Raimundo Janio, Adriana Griz, Antonio Macedo, Valdemar Ortiz
    Abstract:

    Introduction: Nowadays, buccal mucosa grafts are the most successful method to reconstruct bulbar urethral strictures. Dorsal placement of the graft has been recently proposed, allowing the graft to be spread fixed on the Tunica albuginea of the corporal bodies overlying the stricture. The dorsal graft is ingenious and represents a useful addition to the surgical armamentarium, since it offers a better chance for graft take than does the spongiosum when the urethra is diseased and poorly vascularized. We developed an additional reconstructive option using Tunica Vaginalis grafts, placed dorsally, fo

  • the Tunica Vaginalis dorsal graft urethroplasty initial experience
    International Braz J Urol, 2007
    Co-Authors: Roberto C Foinquinos, Adriano A Calado, Raimundo Janio, Adriana Griz, Antonio Macedo
    Abstract:

    INTRODUCTION: Nowadays, buccal mucosa grafts are the most successful method to reconstruct bulbar urethral strictures. Dorsal placement of the graft has been recently proposed, allowing the graft to be spread fixed on the Tunica albuginea of the corporal bodies overlying the stricture. The dorsal graft is ingenious and represents a useful addition to the surgical armamentarium, since it offers a better chance for graft take than does the spongiosum when the urethra is diseased and poorly vascularized. We developed an additional reconstructive option using Tunica Vaginalis grafts, placed dorsally, for the treatment of anterior urethral strictures. SURGICAL TECHNIQUE: A total of 11 patients with anterior urethral strictures were treated with a Tunica Vaginalis graft urethroplasty. The surgical technique was done as described by Barbagli. The urethra was dissected from the corpora cavernosa and rotated 180 degrees. The dorsal urethral surface was exposed and fully opened. Both the distal and proximal lumina were calibrated. The Tunica Vaginalis graft was sutured, splayed and quilted over the corpora cavernosa using 6-0 PDS running stitches. The left side of the urethral mucosa was sutured to the graft using 6-0 PDS sutures. A 18F silicone Foley catheter was inserted at this point. The urethra was rotated back to its original position and sutured laterally to the right side of the graft. At the end of the procedure, the graft was completely covered by the urethra. With a follow-up ranging from 7 weeks to 5 months, all patients were voiding well (uroflowmetry > 14 mL per second). CONCLUSION: This initial experience in 11 patients indicates that Tunica Vaginalis dorsal graft urethroplasty may be considered within the reconstructive armamentarium of genitourinary surgeons.

  • the Tunica Vaginalis dorsal graft urethroplasty experimental study in rabbits
    The Journal of Urology, 2005
    Co-Authors: Adriano A Calado, J Antonio R Macedo, Rosana Delcelo, Luiz Francisco Poli De Figueiredo, Valdemar Ortiz, Miguel Srougi
    Abstract:

    ABSTRACTPurpose: We created an experimental model of urethral defect and then repaired it using a Tunica Vaginalis graft applied on the dorsal surface of the urethra. We studied the histological and radiological characteristics of free Tunica Vaginalis graft urethroplasty.Materials and Methods: In 20 New Zealand rabbits a dorsal urethral defect was created by excising a portion of the dorsal urethral surface. The Tunica Vaginalis graft was placed dorsally over the corpora cavernosa and tied with 4 interrupted sutures. The mucosal margin of the urethral defect was sutured to the graft using 6–zero polydioxanone sutures in continuous fashion. The animals were divided into 4 equal groups and were sacrificed 14 days, and 4, 8 and 12 weeks after surgery, respectively. A retrograde urethrogram was done at autopsy. The penis was sent for histological analysis and an experienced pathologist evaluated the severity of acute and chronic inflammation, foreign body reaction and scar formation.Results: There were no de...