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Abstract

Volume 20, Issue 5 (September 2018) 20, 488–492; 10.4103/aja.aja_35_18

Repeated penile girth enhancement with biodegradable scaffolds: Microscopic ultrastructural analysis and surgical benefits

Miroslav L Djordjevic1,2, Uros Bumbasirevic3, Borko Stojanovic2, Tamara Kravic Stevovic1, Tamara Martinovic1, Marta Bizic1,2, Vladimir Kojovic1

1 School of Medicine, University of Belgrade, Belgrade 11000, Serbia
2 University Children’s Hospital, Belgrade 11000, Serbia
3 Institute for Urology, Clinical Center of Serbia, Belgrade 11000, Serbia

Correspondence: Dr. ML Djordjevic (djordjevic@uromiros.com)

01-Jun-2018Date of Submission 02-Nov-2017 Date of Acceptance 04-Apr-2018 Date of Web Publication 01-Jun-2018

Abstract

Autologous tissue engineering using biodegradable scaffolds as a carrier is a well-known procedure for penile girth enhancement. We evaluated a group of previously treated patients with the aim to analyze histomorphometric changes after tissue remodeling and to estimate the benefits of repeated procedure. Between February 2012 and December 2016, a group of 21 patients, aged 22–37 (mean 28.0) years, underwent a repeated penile girth enhancement procedure with biodegradable scaffolds. Procedure included insertion of two poly-lactic-co-glycolic acid scaffolds seeded with laboratory-prepared fibroblasts from scrotal tissue specimens. During this procedure, biopsy specimens of tissue formed after the first surgery were taken for microscopic analysis. The mean follow-up was 38 months. Connective tissue with an abundance of connective tissue fibers, small blood vessels, and inflammatory cells were observed in all analyzed surgically removed tissue. Ultrastructural analysis of these tissue samples discovered the presence of large quantities of collagen fibrils running parallel to each other, forming bundles, with a few widely spread fibroblasts. In total, the mean values of flaccid and erect gain in girth after the second surgery were 1.1 ± 0.4 (range: 0.6–1.7) cm and 1.0 ± 0.3 (range: 0.6–1.5) cm, respectively. Microscopic evaluation of newly formed tissue, induced by autologous tissue engineering using biodegradable scaffolds, showed the presence of vascularized loose connective tissue with an abundance of collagen fibers, fibroblasts, and inflammatory cells, indicating active neovascularization and fibrinogenesis. The benefit of the repeated enhancement procedure was statistically significant.

Keywords: biodegradable scaffolds; microscopy; penile enhancement; tissue engineering

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