Objective: To investigate the efficacy of using everted saphenous vein graft for urethral reconstruction. Materials and Methods: Thirty-five adult male rabbits were divided into 7 groups randomly: experimental group A, B, C, D, E, stricture control group and normal control group (n = 5). In experimental groups and the stricture control group, a urethral mucosa defect (1.5 × 0.8 cm) was created in each rabbit. In experimental groups, a 2-cm long saphenous vein graft was harvested and incised longitudinally and urethral reconstruction was carried out using the everted saphenous vein patch. Rabbits in experimental group A-E were killed respectively at 1 week, 2 weeks, 1 month, 3 months, and 1 year postoperatively, and the specimens were obtained for histo-pathological examination. Retrograde urethrography was performed to evaluate urethral patency before sacrifice in group D and the stricture control group. Results: In the histo-pathological study, the vein grafts were visible within first week. The vein graft was completely covered by epithelium 1 month postoperatively. Retrograde urethrograms showed the urethral caliber of experimental rabbits were similar to those of normal. While the stricture control group showed a narrow urethral lumen and urothelium defect. Conclusions: For urethral reconstruction, everted saphenous vein graft can be an ideal substitute material because of its longer survival time and rapid epithelization capacity.

1.
Zhou SK, Zhang J, Sa YL, Jin SB, Xu YM, Fu Q, Lazzeri M: Etiology and management of male iatrogenic urethral stricture: retrospective analysis of 172 cases in a single medical center. Urol Int 2016;97:386-391.
2.
Hendren WH, Horton CE Jr: Experience with 1-stage repair of hypospadias and chordee using free graft of prepuce. J Urol 1988;140(5 pt 2):1259-1264.
3.
Liu JS, Han J, Said M, Hofer MD, Fuchs A, Ballek N, Gonzalez CM: Long-term outcomes of urethroplasty with abdominal wall skin grafts. Urology 2015;85:258-262.
4.
Mollard P, Mouriquand P, Bringeon G, Bugmann P: Repair of hypospadias using a bladder mucosal graft in 76 cases. J Urol 1989;142:1548-1550.
5.
Fransis K, Vander Eeckt K, Van Poppel H, Joniau S: Results of buccal mucosa grafts for repairing long bulbar urethral strictures. BJU Int 2010;105:1170-1172.
6.
Lebret T, Gobet F, Dallaserra M, Mitrofanoff P: Use of a digestive mucosal graft in urethroplasty. An experimental study - prospective utilization of the appendix mucosa. Eur Urol 1995;27:58-61.
7.
Sievert KD, Amend B, Stenzl A: Tissue engineering for the lower urinary tract: a review of a state of the art approach. Eur Urol 2007;52:1580-1589.
8.
Guo H, Sa Y, Huang J, Wang Z, Wang L, Xie M, Lv X: Urethral reconstruction with small intestinal submucosa seeded with oral keratinocytes and TIMP-1 siRNA transfected fibroblasts in a rabbit model. Urol Int 2016;96:223-230.
9.
Mangera A, Chapple CR: Tissue engineering in urethral reconstruction - an update. Asian J Androl 2013;15:89-92.
10.
Bhargava S, Patterson JM, Inman RD, MacNeil S, Chapple CR: Tissue-engineered buccal mucosa urethroplasty-clinical outcomes. Eur Urol 2008;53:1263-1269.
11.
Osman NI, Hillary C, Bullock AJ, MacNeil S, Chapple CR: Tissue engineered buccal mucosa for urethroplasty: progress and future directions. Adv Drug Deliv Rev 2015;82-83:69-76.
12.
Kropfl D, Tucak A, Prlic D, Verweyen A: Using buccal mucosa for urethral reconstruction in primary and re-operative surgery. Eur Urol 1998;34:216-220.
13.
Xu YM, Qiao Y, Sa YL, Zhang J, Fu Q, Song LJ: Urethral reconstruction using colonic mucosa graft for complex strictures. J Urol 2009;182:1040-1043.
14.
Lee YJ, Kim SW: Current management of urethral stricture. Korean J Urol 2013;54:561-569.
15.
Brannan W, Ochsner MG, Fuselier HA, Goodlet JS: Free full thickness skin graft urethroplasty for urethral stricture: experience with 66 patients. J Urol 1976;115:677-680.
16.
Vyas PR, Roth DR, Perlmutter AD: Experience with free grafts in urethral reconstruction. J Urol 1987;137:471-474.
17.
Rao AR, Shergill I, Thwaini A, Karim O, Motiwala H: Oral complications after buccal mucosal graft harvest for urethroplasty. BJU Int 2005;95:679.
18.
Wood DN, Allen SE, Andrich DE, Greenwell TJ, Mundy AR: The morbidity of buccal mucosal graft harvest for urethroplasty and the effect of nonclosure of the graft harvest site on postoperative pain. J Urol 2004;172:580-583.
19.
Xu YM, Qiao Y, Sa YL, Wu DL, Zhang J, Zhang XR, Chen R, Si JM: 1-stage urethral reconstruction using colonic mucosa graft for the treatment of a long complex urethral stricture. J Urol 2004;171:220-223; discussion 223.
20.
Uchikawa-Tani Y, Yazawa M, Sakuma H, Hikosaka M, Takayama M, Kishi K: Reconstruction of the urethral sphincter with dynamic graciloplasty in a male rabbit model. Urol Int 2016;96:217-222.
21.
Kjaer TB, Nilsson T, Madsen PO: Total replacement of part of the canine urethra with lyophilized vein homografts. Invest Urol 1976;14:159-161.
22.
Frang D, Furka I, Koves S: Urethral replacement with autologous venous graft: an experimental study in the dog. Urol Res 1982;10:145-147.
23.
Kahveci R, Kahveci Z, Sirmali S, Ozcan M: Urethral reconstruction with autologous vein graft: an experimental study. Br J Plast Surg 1995;48:500-503.
24.
Hubner W, Rurka I, Porpaczy P, Miko I: Autologous everted vein graft for repairing long-section urethral defects. Urol Res 1991;19:131-134.
25.
Foroutan HR, Khalili A, Geramizadeh B, Rasekhi AR, Tanideh N: Urethral reconstruction using autologous and everted vein graft: an experimental study. Pediatr Surg Int 2006;22:259-262.
26.
Kim BS, Kim HT, Kwon SY, Chun SY, Choi KH, Park M, Kim DH, Song PH, Kwon TG: Nontransected ventral onlay-augmented urethroplasty using autologous saphenous vein graft in a rabbit model of urethral stricture. Urology 2014;83:225-231.
27.
Shaeer OK, El-Sadat A: Urethral substitution using vein graft for hypospadias repair. J Pediatr Urol 2006;2:518-521.
28.
Xu YM, Sa YL, Qiao Y, Zhang HZ, Zhang XR, Zhang J, Chen Z, Xie H, Si JM, Li T: Histopathological changes of free buccal mucosa and colonic mucosa grafts after translation to dog bladder. Chin Med J (Engl) 2005;118:337-339.
29.
Sabbagh W, Masters JR, Duffy PG, Herbage D, Brown RA: In vitro assessment of a collagen sponge for engineering urothelial grafts. Br J Urol 1998;82:888-894.
30.
Cavalcanti AG, Costa WS, Baskin LS, McAninch JA, Sampaio FJ: A morphometric analysis of bulbar urethral strictures. BJU Int 2007;100:397-402.
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