Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2020, vol. 29, nr 11, November, p. 1367–1373

doi: 10.17219/acem/123353

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Experimental study on the repair of ureteral functional regeneration with highly bioactive extracellular matrix stent

Lifeng Gu1,A, Xiaosong Fan1,A, Jiancheng Lu1,B, Bojun Li1,B, Weijie Xia1,C, Feiping He1,D,E, Jie Chen1,D,E, Weixing Yu1,F

1 Department of Urology, Shaoxing Shangyu People’s Hospital, China


Background. The research of extracellular matrix stent (ECM) has made some progress in the repair of urethra and bladder defects.
Objectives. To observe the effects of highly bioactive ECM scaffold on the regeneration and repair of defects in long-segment ureteral replacement.
Material and Methods. An animal model of long-segment ureteral defect was established and four-layer tubular highly bioactive ECM materials were prepared. After the ureteral defect was repaired through surgery, the rabbits in the negative control group were administered a non-bioactive stent, and rabbits in the observation group were treated with an ECM stent.
Results. Comparison of macro-indicators: The negative control group had a higher infection rate, a lower survival rate and more complications than the observation group (p < 0.05). The frequency of ureteral peristalsis in the negative control group was lower than in the observation group. In addition, the rate of urinary dysfunction was higher, and the ratio of ureteral diameter was lower in the negative control group than in the observation group (all p < 0.05). Comparison of histopathology: Three months after the operation, the vascular, smooth muscle and mucous membrane of the ureter in the observation group regenerated to close to normal ureteral tissue. There was no significant difference between the ureter regeneration in the repair area and the normal ureter tissue in the observation group 3 months after the operation. The number of regenerated muscle fibers in the observation group was significantly higher than that of the negative control group. Compared with the negative control group, the fibrous capsule was thicker, the percentages of CD31, CD3, CD68, CD80+, and CD163+ were higher, the scope of new smooth muscle fiber was expanded, fusion with the host muscle fibers was higher, and the neuromuscular junction (NMJ) structure was stronger in the observation group (all p < 0.05).
Conclusion. A highly bioactive ECM stent can better regenerate the local anatomical structure and physiological function.

Key words

extracellular matrix, ureteral defect, high biological activity, regeneration and repair

References (21)

  1. Siddighi S, Yune JJ, Kwon NB, Hardesty JS, Kim JH, Chan PJ. Perioperative serum creatinine changes and ureteral injury. Int Urol Nephrol. 2017;49(11):1915–1919.
  2. Choi YS, Lee SH, Cho HJ, Lee DH, Kim KS. Outcomes of ureteroscopic double-J ureteral stenting for distal ureteral injury after gynecologic surgery. Int Urogynecol J. 2018;29(9):1397–1402.
  3. Ordorica R, Wiegand LR, Webster JC, Lockhart JL. Ureteral replacement and onlay repair with reconfigured intestinal segments. J Urol. 2014;191(5):1301–1306.
  4. Tokhmafshan F, Brophy PD, Gbadegesin RA, Gupta IR. Vesicoureteral reflux and the extracellular matrix connection. Pediatr Nephrol. 2017;32(4):565–576.
  5. Zhao Z, Liu D, Chen Y, et al. Ureter tissue engineering with vessel extracellular matrix and differentiated urine-derived stem cells. Acta Biomater. 2019;88:266–279.
  6. Yi S, Ding F, Gong L, Gu X. Extracellular matrix scaffolds for tissue engineering and regenerative medicine. Curr Stem Cell Res Ther. 2017;12(3):233–246.
  7. Lazica DA, Ubrig B, Brandt AS, von Rundstedt FC, Roth S. Ureteral substitution with reconfigured colon: Long-term follow-up. J Urol. 2012;187(2):542–548.
  8. Kloskowski T, Kowalczyk T, Nowacki M, Drewa T. Tissue engineering and ureter regeneration: Is it possible? Int J Artif Organs. 2013;36(6):392–405.
  9. Simaioforidis V, de Jonge P, Sloff M, Oosterwijk E, Geutjes P, Feitz WFJ. Ureteral tissue engineering: Where are we and how to proceed? Tissue Eng Part B Rev. 2013;19(5):413–419.
  10. Sapora JA, Hardie RJ, Evans N. Use of a subcutaneous ureteral bypass device for treatment of bilateral proximal ureteral injury in a 9-month-old cat. JFMS Open Rep. 2019;5(1):2055116919831856.
  11. Zhang J, Hu Z, Billiar TR, Badylak SF. Preparation of volumetric skeletal muscle whole organ acellular matrix to regenerate contractile, vascularized, innervated muscle in rodent and canine model. J Am Coll Surg. 2013;217(3):S145.
  12. Song JJ, Guyette JP, Gilpin SE, Gonzalez G, Vacanti JP, Ott HC. Regeneration and experimental orthotopic transplantation of a bioengineered kidney. Nat Med. 2013;19(5):646–651.
  13. Versteegden LR, van Kampen KA, Janke HP, et al. Tubular collagen scaffolds with radial elasticity for hollow organ regeneration. Acta Biomater. 2017;52:1–8.
  14. Xiao S-W, Wang P-C, Fu W-J, Wang Z-X, Li G, Zhang X. Novel perfusion-decellularized method to prepare decellularized ureters for ureteral tissue-engineered repair. J Biosci Bioeng. 2016;122(6):758–764.
  15. Murala JSK, Sassalos P, Owens ST, Ohye RG. Porcine small intestine submucosa cylinder valve for mitral and tricuspid valve replacement. J Thorac Cardiovasc Surg. 2017;154(3):e57–e59.
  16. Guest JF, Weidlich D, Singh H, et al. Cost-effectiveness of using adjunctive porcine small intestine submucosa tri-layer matrix compared with standard care in managing diabetic foot ulcers in the US. J Wound Care. 2017;26(Suppl 1):S12–S24.
  17. Zhang X, Fang Z, Cho E, et al. Use of a novel, reinforced, low immunogenic, porcine small intestine submucosa patch to repair a supraspinatus tendon defect in a rabbit model. Biomed Res Int. 2019;2019:9346567–9346567.
  18. Chai Y, Xu J, Zhang Y, Zhang J, Hu Z, Zhou H. Evaluation of decellularization protocols for production of porcine small intestine submucosa for use in abdominal wall reconstruction. Hernia. 2019. doi:10.1007/s10029-019-01954-4.
  19. Sous Naasani LI, Rodrigues C, Azevedo JG, Damo Souza AF, Buchner S, Wink MR. Comparison of human denuded amniotic membrane and porcine small intestine submucosa as scaffolds for limbal mesenchymal stem cells. Stem Cell Rev Rep. 2018;14(5):744–754.
  20. Nherera LM, Romanelli M, Trueman P, Dini V. An overview of clinical and health economic evidence regarding porcine small intestine submucosa extracellular matrix in the management of chronic wounds and burns. Ostomy Wound Manage. 2017;63(12):38–47.
  21. Bryant D, Holtby R, Willits K, et al. A randomized clinical trial to compare the effectiveness of rotator cuff repair with or without augmentation using porcine small intestine submucosa for patients with moderate to large rotator cuff tears: A pilot study. J Shoulder Elbow Surg. 2016;25(10):1623–1633.