Abstract

APPLICATION OF HUMAN AMNIOTIC MEMBRANE (HAM) GRAFT IN THE DONKEYS PENILE CORPUS CAVERNOSUM DEFECT; DEVELOPING AN ANIMAL MODEL NEW METHOD FOR THE TREATMENT OF PEYRONIE’S DISEASE, PENILE CANCERS, AND CONGENITAL DEFORMITI

Dinyar Khazaeli.MD, Hadi Naddaf. DVM ,Mahziyar Khazaeli.MD, Nastaran Ranjbari. MD, Ali Goudarzi Karim.MD, Saeid Hosseini MD, Alireza Alishushtari.MD, Amirhossein Mavadati. DVM

Abstract

Purposes: To evaluate the efficacy of human amniotic membrane (AM) grafting in the Donkeys penile Corpus cavernosum defect; we developed an animal model new method for the treatment of Peyronie’s disease, penile cancers, and congenital deformities of the penis Materials and methods: 5 one-year-old donkeys of 150-200 kg weight has been included to our study. After induction of general anaesthesia penile skins were degloved and dorsal penile neurovascular bundles were dissected off the corpora cavernosa. Then a 4x5 cm rhomboid incision made at the mid part of the corpora cavernosa. Then a double folded patch of human amniotic membrane filled the induced defect after which the penile skin closure and sub cutaneous drain were made. After a two-month period all the animals were operated once again regarding penile deformity and stability, then total penectomy performed and the specimens sent to pathologist for histopathologic exams. Using statistical and pathological assessments, all variables were evaluated. Results: Except in one animal which encountered severe penile infection and edema, all others animals well tolerated the recovery period. There were no death due the surgery, however in the first case there was a massive tissue fibrosis. Four healthy donkeys remained in our study. The average HAM patch size before the surgery was 4.65 cm (4.4 – 5 cm, SD= 0.3 cm) which became 4.20 cm (3.9-4.4 cm, SD= 0.22 cm) after an 8-week follow up surgery. The average patch contraction was 9.58% (4.5-12%, SD= 3.41%). No penile deformity or instability were seen in 4 animals. Histopathologic evaluation confirmed complete re-epithelialization of HAM. Conclusions: The amniotic membrane can be used as a suitable substitution for corpus cavernosum. 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.

Keywords: human amniotic membrane, HAM, corpus cavernosum, donkey.