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OBJECTIVES To evaluate the ability of photocurable gelatin to prevent stricture recurrence after urethral dilation in a rabbit urethral stricture model. METHODS We created urethral strictures in the bulbar urethras of 10 male Japanese white rabbits using electrocoagulation. After 1 month, the rabbits were randomly divided into Group A (n = 5; urethral stricture dilation and the local application of photocurable gelatin using a ruthenium photoinitiator and irradiation with a light-emitting diode light [λ = 455 nm, 50 mW/cm2 ] for 1 min) and Group B (n = 5; dilation only). Urethral stricture status was evaluated 1-2 months later by retrograde urethrography and urethroscopy. The lumen ratio (urethral width at the stricture site to the normal urethral width on retrograde urethrography) was calculated. Urethral patency was considered to be improved when the urethral lumen could accommodate a 10-Fr urethroscope without resistance. Urethral specimens were harvested for histopathological examination. RESULTS The mean lumen ratio did not differ significantly between Groups A and B before dilation (25.8% vs 23.4%; P = 0.40), but differed significantly after dilation (65.5% vs 27.3%, respectively; P = 0.03). Urethral patency improved in all rabbits in Group A (100%) versus one rabbit in Group B (20%; P = 0.02). The mean circumference of the regenerated urethral epithelium at the stricture site was larger in Group A than in Group B (14 mm vs 6.6 mm; P = 0.06). CONCLUSIONS Photocurable gelatin can reduce urethral stricture recurrence after dilation in a rabbit model.

Urethral stricture disease is a commonly presenting problem to the urologist. Any condition that damages the urethral epithelium or underlying spongy tissue has the potential to cause a stricture. Patients with a urethral stricture can present either acutely or chronically with a range of urinary symptoms. An understanding of urethral stricture disease and a systematic approach to the history and investigations will enable clinicians to manage patients appropriately. This article aims to give an overview, appropriate for surgeons in there early years of training, on the aetiology, presentation and investigation of urethral stricture disease, as well as a basic understanding of the principles of management.

INTRODUCTION AND OBJECTIVE:Lichen sclerosus (LS) is a chronic inflammatory condition that can affect both the penile skin and urethral epithelium in men. Over time, severe impairment of sexual and ...

Background This study aims to screen the male human papillomavirus (HPV) infection status and genotyping in Qingcheng District, Qingyuan City, Guangdong Province, China to provide a reference basis for formulating prevention strategies for HPV infection. Methods The present study collected urethral epithelium or scraped penile epidermis from high-risk male patients in Qingyuan People's Hospital during the last five years, extracted DNA fragments using the boiling method, and detected 23 types of HPV genotypes by PCR-reverse blot hybridization. Results The positive detection rate was 54.31% of 1044 males with high risk of HPV (567/1044). Among these males, the positive detection rate of HPV was the highest in patients initially diagnosed with warts, and the rate was 66.47%. Five main HPV types are identified as follows: HPV6 18.87% (197/1044), HPV11 10.25% (107/1044), HPV52 8.81% (92/1044), HPV16 6.90% (72/1044), and HPV51 5.08% (53/1044). Among these HPV-infected patients, single infection mainly by low-risk HPV6 and HPV11 accounted for 56.61% (321/567); high- and low-risk combined HPV co-infections accounted for 29.10% (165/567). The HPV infected patients was mainly between 21 and 40 years old, and the HPV infection rate was higher with increased age. Conclusions The HPV infection rate in the Qingyuan area is higher than in other areas and the main infection is single infection. Furthermore, HPV52, HPV16, and HPV51 are the main high-risk infection types, while HPV6 and HPV11 are the main low-risk infection types.

Целью исследования было изучить роль растворимых молекул межклеточной адгезии (ICAM-1, VCAM) в патогенезе персистирующего негонококкового уретрита у мужчин, индуцированного C. trachomatis, U. urealyticum, M. genitalium и определить их возможную связь с содержанием в уретральных смывах цитокинов ( ИЛ-6, ИЛ-8). Выводы: Цитокины с ХЕМОКИНОВОГО активностью (ИЛ-6, ИЛ-8) и растворимые молекулы межклеточной адгезии (ICAM-1, VCAM) являются ключевыми факторами патогенеза персистирующего пост-Эрадикационная уретрита, что подтверждается наличием статистически достоверных различий по медианным содержания этих медиаторов между пациентами с персистенцией симптомов и клиническим выздоровлением. Цитокины (ИЛ-6, ИЛ-8) и адгезивные молекулы (ICAM-1, VCAM) имеют синергетический влияние, способствуя рекрутинга и депонированию имунокомпетент-ных клеток, на что указывает наличие корреляции между концентрациями этих медиаторов. Дальнейшие исследования должны быть направлены на установление механизмов развития конкретных симптомов и способов их коррекции., Метою дослідження було вивчити роль розчинних молекул міжклітинної адгезії (ICAM-1, VCAM) у патогенезі персистуючого негонококового уретриту у чоловіків, індукованого C. trachomatis, U. urealyticum, M. genitalium і визначити їх можливий зв’язок з вмістом в уретральних змивах цитокінів (ІЛ-6, ІЛ-8). Висновки: Цитокіни з хемокіновою активністю (ІЛ-6, ІЛ-8) та розчинні молекули міжклітинної адгезії (ICAM-1, VCAM) є ключовими факторами патогенезу персистуючого пост-ерадикаційного уретриту, що підтверджується наявністю статистично достовірних відмінностей за медіанним вмісту цих медіаторів між пацієнтами з персистенцією симптомів і клінічним одужанням. Цитокіни (ІЛ-6, ІЛ-8) та адгезивні молекули (ICAM-1, VCAM) мають синергічний вплив, сприяючи рекрутингу та депонуванню імунокомпетент-них клітин, на що вказує наявність кореляції між концентраціями цих медіаторів. Подальші дослідження повинні бути спрямовані на встановлення механізмів розвитку конкретних симптомів і способів їх корекції., The purpose of the study was to investigate the role of soluble intercellular adhesion molecules (ICAM-1, VCAM) in the pathogenesis of persistent non-gonococcal urethritis in men induced by C.trachomatis, U.urealyticum, M. genitalium and to determine their possible association with the content of cytokines in urethral cytokines (IL -6, IL-8). Conclusions: Cytokines with chemokine activity (IL-6, IL-8) and soluble intercellular adhesion molecules (ICAM-1, VCAM) are key factors in the pathogenesis of persistent post-eradication urethritis, which is confirmed by statistically significant differences in the median concentrations of these mediators between patients with persistence Symptoms and clinical cure. Cytokines (IL-6, IL-8) and adhesive molecules (ICAM-1, VCAM) have synergistic effects that promote the recruitment and deposition of immunocompetent cells, as indicated by the presence of a correlation between the concentrations of these mediators. Further studies should be aimed at establishing mechanisms for the development of specific symptoms and ways to correct them.

Management of problems after menopause is an important aspect of routine gynecological practice. Age related changes include thinning of trigonal and urethral epithelium, decrease in blood flow through urethral plexus resulting in reduced cooptation, and overall connective tissue (elasticity, striated muscles and total collagen) diminution. The effects on other organ systems and comorbidities add to urological problems in the aged.Though it is very difficult to attribute all these changes to aging, estrogen deprivation after menopause seems to contribute significantly to the urological problems. The problems are more cumbersome in the elderly worsened by thecomorbidities. Incontinence of any kind is abnormal regardless of any age. Treatment of the factors beyond the bladder for the voiding related worries including incontinence is required. A multipronged, creative, persistent and optimistic approach is needed to treat these cases.

BACKGROUND: Tissue-engineered (TE) urethra is desirable in men with urethral disease (stricture or hypospadias) and shortage of local tissue. Although ideally a TE graft would contain urethral epithelium cells, currently, bladder epithelium (urothelium) is widely used, but morphologically different. Understanding the differences and similarities of urothelium and urethral epithelium could help design a protocol for in vitro generation of urethral epithelium to be used in TE grafts for the urethra. PURPOSE: To understand the development toward urethral epithelium or urothelium to improve TE of the urethra. METHODS: A literature search was done following PRISMA guidelines. Articles describing urethral epithelium and bladder urothelium development in laboratory animals and humans were selected. RESULTS: Twenty-nine studies on development of urethral epithelium and 29 studies on development of urothelium were included. Both tissue linings derive from endoderm and although adult urothelium and urethral epithelium are characterized by different gene expression profiles, the signaling pathways underlying their development are similar, including Shh, BMP, Wnt, and FGF. The progenitor of the urothelium and the urethral epithelium is the early fetal urogenital sinus (UGS). The urethral plate and the urothelium are both formed from the p63+ cells of the UGS. Keratin 20 and uroplakins are exclusively expressed in urothelium, not in the urethral epithelium. Further research has to be done on unique markers for the urethral epithelium. CONCLUSION: This review has summarized the current knowledge about embryonic development of urothelium versus urethral epithelium and especially focuses on the influencing factors that are potentially specific for the eventual morphological differences of both cell linings, to be a basis for developmental or tissue engineering of urethral tissue.

Tissue engineering-based urethral replacement holds potential for repairing large segmental urethral defects, which remains a great challenge at present. This study aims to explore the potential of combining biodegradable poly(l-lactide) (PLLA)/poly(ethylene glycol) (PEG) scaffolds and human amniotic mesenchymal cells (hAMSCs) for repairing urethral defects. PLLA/PEG fibrous scaffolds with various PEG fractions were fabricated via electrospinning. The scaffolds were then seeded with hAMSCs prior to implantation in New Zealand male rabbits that had 2.0 cm-long defects in the urethras. The rabbits were randomly divided into three groups. In group A, hAMSCs were grown on PLLA/PEG scaffolds for two days and then implanted to the urethral defects. In group B, only the PLLA/PEG scaffolds were used to rebuild the rabbit urethral defect. In group C, the urethral defect was reconstructed using a regular urethral reparation technique. The repair efficacy was compared among the three groups by examining the urethral morphology, tissue reconstruction, luminal patency, and complication incidence (including calculus formation, urinary fistula, and urethral stricture) using histological evaluation and urethral radiography methods. Findings from this study indicate that hAMSCs-loaded PLLA/PEG scaffolds resulted in the best urethral defect repair in rabbits, which predicts the promising application of a tissue engineering approach for urethral repair.

The aim of this study was to investigate by histological techniques the structure of urethral epithelium in lambs. In this study, we harvested several fragments (prostatic, membranous and cavernous) from urethra from 5 merino’s lambs of 3 months old. The first anatomical segment, the prostatic urethra, is lined by a urinary epithelium. The intermediary layer of this epithelium is formed of 5-6 rows of oval cells. The second segment of urethra has the same type of epithelium but the intermediary layer is formed of 6-7 rows of oval cells. In the last anatomical segment, the penile urethra, the epithelium is the same, but the intermediary layer has 3-4 rows of oval cells. In lambs, the urethra is lined by urinary epithelium. The urethral epithelium does not have the same thickness in all segments. The thinner epithelium it is in the cavernous urethra, the ticker is the membranous urethra.

Primary carcinoma of the male urethra accounts for less than 1% of malignancies in males. Mucinous adenocarcinoma of the urethra is extremely rare, and its biologic behavior is not well known. We report a case of mucinous adenocarcinoma showing the histologic features of colloid adenocarcinoma that appears to have evolved either by neoplastic degeneration of goblet cells found in the urethral epithelium or by malignant degeneration of persistent glandular elements of uretheritis cystica and glandularis.

Objective. The urethra is the main port of entry of sexually transmitted pathogens. However, papers on the morphology of the urethra are scarce. The Mongolian gerbil is a rodent native of the Mongolia and China and has been utilized as a laboratory animal since the 1960s. This work describes the ultrastructure of the urethra of the Mongolian gerbil to provide data for future experimental studies. Methods. The urethra of ten adult male gerbils was studied by transmission electron microscopy. Results. The epithelium of the pelvic urethra possesses two cell types: I and II, without the formation of cellular layers, while the penile urethra possesses cellular layers: basal, intermediate and superficial. The urethra presents neurosecretory cells belonging to the amine precursor uptake and decarboxylation system. Conclusions. The urethral epithelium of the gerbil is a neurosecretory epithelium, part of the amine precursor uptake and decarboxylation system.

HYPOSPADIAS is a congenital defect in which the urethra terminates on the ventral surface of the penis. In about 20 percent of cases, the urethral meatus is at the base of the penis, and the anterior urethra is absent. Treatment in these cases requires extensive reconstruction of the anterior urethra, usually with autografts of flaps of contiguous skin or preputial skin transferred with a vascular pedicle.1 Split-thickness skin grafts from other parts of the body have also been used.1 , 2 The presence of pilosebaceous units in skin grafts can lead to problems, however, because of hair growth and sebaceous secretion. More . . .

The aim of this study is to describe the presence of neuroendocrine(NE) cells (paraneurons), producing biogenic amines and/orpeptidergic hormones, in the female urethra of wild mammals, by means of histochemical and double labeling immunotluoresent techniques 5-Hydroxytryptamine-, chromogranin A-, cholecystokininand somatostatin-contain NE cells are present in the urethral epithelium of all the species studied. Paraneurons containing 5-hydroxytryptamine colocalized with chromogranin A or cholecystokinin were also found in all subjects. Such active substances are hypothesized to play a role in the contraction of the urethral musculature, emission of urogenital fluids, and inhibition of endocrine and exocrine secretions.

The transurethral system for erection was developed to deliver vasoactive compounds to the urethral mucosa to treat men with erectile dysfunction. The urethral epithelium just beyond the fossa navicularis shifts from stratified squamous to complex columnar tissue where vasoactive compounds may be absorbed. Following absorption into the corpus spongiosum surrounding the urethra, medications may be subsequently transferred to the corpora cavernosa via collateral vessels.

Male human urethra] epithelium was treated for the immunohistochemical demonstration of secretory IgA in order to verify its own possible antimicrobial properties. An intense immunoreactivity for slgA in the entire cytoplasm and at the luminal surface of the apical epithelial cells was observed. The results suggest that slgA play a prominent role in the local defense mechanisms of the urethra. Such mucosal defense mechanisms may be of significance in the defense of the urinary and genital tract against ascending infections.

Four centimeters of the canine urethra was replaced by a graft consisting of a polyglactin fiber mesh tube, coated with polyhydroxybutyric acid. Microscopic examination 8-12 months later showed almost complete regeneration of the urethral epithelium and the adjacent connective tissue. The neo-urethra was patent and there were no anastomotic strictures, nor was there any inflammatory reaction around the urethra. The validity of this concept in humans remains to be proved.

Urethral strictures are difficult to cure. In 1988, a new treatment was reported, consisting of dilation or incision of the stricture followed by implantation of a specially designed stent meant to allow the urethral epithelium to heal and cover the stent while preventing shrinkage of the scar and reappearance of the stricture. Two cases are reported here in which implantation of the stent resulted in a foreign-body reaction and obstruction of the lumen of the urethra. The area obstructed was reopened by transurethral removal of the reactive tissue. The long-term effect of this reaction on the patency of the urethra is still unknown.

Nine male dogs were subjected to cystoprostatectomy, ileal loop diversion, and urethral hyperthermia. Five of the 9 dogs survived six weeks. Three of the 5 surviving dogs had complete destruction of the urethral epithelium, and the other 2 dogs had 95 per cent and 50 per cent destruction with the proximal urethral end incompletely destroyed. Complete urethral destruction may have been obtained with resection of the proximal urethra post-irrigation. The irrigation added no extra time to the surgical procedure and was accompanied by few complications. Complications may have been averted with a dorsal slit and meatotomy.

The urethral mucosa of the rat, rabbit and guinea-pig was examined with both fluorescence and electron microscopy. Employing the former technique, numerous brightly fluorescing flask-shaped cells were observed amongst the basal cells of the urethral epithelium in all three species. In the electron microscope cells with a similar shape and distribution are distinguished by their content of membrane-limited dense granules, extensive Golgi membranes and bundles of filaments. In favourable planes of section short microvilli extend from the apical region of these cells which are joined to neighbouring urethral epithelial cells by zonulae occludentes. These fluorescent, granule-containing cells are classified as urethral chromaffin cells.

Daily subcutaneous injections of pharmacological doses of 17 beta-estradiol (E2, 0.4 micrograms./gm. body weight) resulted in significant urinary retention in the bladder of castrated mice. Although the urinary retention developed in both male and female mice, the increase in urethral resistance to urinary flow and the dilatation of posterior urethra were observed only in castrated male mice receiving E2. Histological changes common to male and female mice were cornification and stratification of urethral epithelium and fibrosis of connective tissues surrounding the urethra, suggesting that these changes may cause the urinary retention. Although the exact mechanism has not been defined, the urinary retention produced by the present method may be useful as a model of human disease.

The previous chapter considered prostatic carcinomas of acinar origin arising in the peripheral portion of the gland. Over the last 20 years or so it has been recognized that a small proportion of primary prostatic carcinomas arise from ductal and urethral epithelium in the centre of the gland. Not unexpectedly these tumours frequently present with obstructive symptoms and haematuria and there is some evidence that they are less likely to respond to oestrogen therapy — this could also be postulated on theoretical considerations since they arise from what has sometimes been called the female portion of the prostate. The central location of these tumours would also suggest that they might be more suitable for radical surgery than the typical peripheral cancer but this has yet to be adequately evaluated1.