Application of Human Amniotic Membrane in Canine Penile Tunica Albuginea Defect: First Step toward an Innovating New Method for Treatment of Peyronie?s Disease

Purposes To evaluate the efficacy of human amniotic membrane (AM) grafting in the canine penile tunica albuginea defect; we developed an animal model as the first step toward an innovating new method for the treatment of Peyronie’s disease, penile cancers, and congenital deformities of the penis. Material and Methods From August to September 2011, ten healthy male dogs were selected. A rhomboid incision about 3x2cm over the tunica albuginea and its overlying squamous epithelium was made and then excised. The amniotic membrane was folded twice on itself and grafted on the defect. After 8 weeks, artificial erection was made for 5 dogs and for the other 5 dogs after 12 weeks. After artificial erection, partial penectomy was done and histopathological evaluation was performed on the grafts. Results Artificial erection performed successfully in all of the dogs. No infection or any other complication was seen. Histopathological examination showed complete re-epithelialization with squamous epithelium and collagen fiber deposition. Also, no dysplasia was seen. Conclusions The amniotic membrane can be used as a suitable substitution for tunica albuginea. It is safe, inexpensive, biodegradable, and available and may be used for the treatment of Peyronie’s disease, penile cancers, congenital penile deformities, and penile reconstructive surgery.

研究目的 本研究旨在评估人羊膜（human amniotic membrane, AM）移植修复犬阴茎白膜（tunica albuginea）缺损的效果，以此作为开发创新治疗方案的前期基础，用于佩罗尼病（Peyronie’s disease）、阴茎癌及先天性阴茎畸形的临床治疗。
材料与方法 2011年8月至9月，选取10只健康雄性犬。于阴茎白膜及其表面覆盖的鳞状上皮（squamous epithelium）处制作约3cm×2cm的菱形切口并切除组织。将羊膜自身对折两次后，移植至缺损部位。术后8周，对其中5只犬实施人工勃起（artificial erection）造模，剩余5只于术后12周进行该操作。人工勃起完成后，行阴茎部分切除术（partial penectomy），并对移植组织开展组织病理学评估（histopathological evaluation）。
结果 所有犬均成功完成人工勃起造模，未出现感染或其他并发症。组织病理学检查显示，移植区域完全实现再上皮化（re-epithelialization），被鳞状上皮覆盖并伴有胶原纤维（collagen fiber）沉积，且未观察到异型增生（dysplasia）。
结论 人羊膜可作为阴茎白膜的合适替代材料，其具备安全、廉价、可生物降解（biodegradable）且易于获取的优势，可用于佩罗尼病、阴茎癌、先天性阴茎畸形及阴茎重建手术的治疗。