Research and Reports in Urology (May 2021)
Hyaluronic Acid Reduces Fibrosis in a Rabbit Model of Urethral Anastomosis
Abstract
Eliseo Portilla-de Buen,1 Juan Pablo Ramirez-Contreras,2 Jonathan Matias Chejfec-Ciociano,2 Rodrigo Lopez-Falcony,3 David Garcia-Martinez,1 Jose Gonzalo Vazquez-Camacho,4 Clotilde Fuentes-Orozco,2 Francisco Jose Barbosa-Camacho,2 Juan Carlos Ibarrola-Peña,2 Alejandro Gonzalez-Ojeda2 1Surgical Research Division, Western Biomedical Research Center, Western Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, México; 2Biomedical Research Unit 02, Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, México; 3Guanajuato State Transplant Center, Institute of Public Health of Guanajuato, Guanajuato, México; 4Cellular Biology Laboratory, School of Medicine, Instituto Tecnológico de Estudios Superiores de Monterrey, Campus Guadalajara, Jal, MéxicoCorrespondence: Alejandro Gonzalez-OjedaInstituto Mexicano del Seguro Social, Av. Belisario Domínguez # 1000, Colonia Independencia, Guadalajara, 44340, Jalisco, MéxicoTel +52 3331294165Email [email protected]: Urethral stricture caused by fibrosis is a common medical condition, but top-line therapy for this pathology has a high recurrence rate. This study aimed to determine the efficacy of hyaluronic acid (HA) treatment in preventing the development of fibrosis in a rabbit model of urethral anastomosis.Materials and Methods: This experimental study involved 20 rabbits. HA (0.5 mL, 25 μg/mL) was applied in the experimental group (n = 10) during an experimental urethral anastomosis, and sterile saline (0.9%) solution was applied in the control group (n = 10). Animals underwent reoperation 12 weeks later for urethral resection. Fibrosis, inflammation, and urethral diameter were measured by two blinded pathologists at the site of the anastomosis.Results: The amount of inflammatory infiltrate was similar in both groups. The thicknesses of the collagen fiber band were 275.9 ± 62.3 and 373.4 ± 44.3 μm in the study and control groups (p = 0.001), respectively, and the urethral lumen diameters at the anastomosis site at follow-up were 2575 ± 167 and 2382 ± 214 μm, respectively (p = 0.04).Conclusion: HA treatment reduced fibrosis at the anastomosis site during this experiment; we suggest further research to corroborate its efficacy in the treatment of urethral stricture.Keywords: hyaluronic acid, submucosal application, urethral anastomosis, urethral stricture, fibrosis
