Document Detail


Structural alterations of foreskin caused by chronic smoking may explain high levels of urethral reconstruction failure using foreskin flaps.
MedLine Citation:
PMID:  22951163     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objectives: The aim of the present study was to perform a stereological and biochemical analysis of the foreskin of smoker subjects. Materials and Methods: Foreskin samples were obtained from 20 young adults (mean = 27.2 years old) submitted to circumcision. Of the patients analyzed, one group (n = 10) had previous history of chronic smoking (a half pack to 3 packs per day for 3 to 13 years (mean = 5.8 ± 3.2). The control group included 10 nonsmoking patients. Masson 's trichrome stain was used to quantify the foreskin vascular density. Weigert's resorcin-fucsin stain was used to assess the elastic system fibers and Picrosirius red stain was applied to study the collagen. Stereological analysis was performed using the Image J software to determine the volumetric densities. For biochemical analysis, the total collagen was determined as µg of hydroxyproline per mg of dry tissue. Means were compared using the unpaired t-test (p < 0.05). Results: Elastic system fibers of smokers was 42.5 % higher than in the control group (p = 0.002). In contrast, smooth muscle fibers (p = 0.42) and vascular density (p = 0.16) did not show any significant variation. Qualitative analysis using Picrosirius red stain with polarized light evidenced the presence of type I and III collagen in the foreskin tissue, without significant difference between the groups. Total collagen concentration also did not differ significantly between smokers and non-smokers (73.1 µg/mg ± 8.0 vs. 69.2 µg/mg ± 5.9, respectively, p = 0.23). Conclusions: The foreskin tissue of smoking patients had a significant increase of elastic system fibers. Elastic fibers play an important role in this tissue's turnover and this high concentration in smokers possibly causes high extensibility of the foreskin. The structural alterations in smokers' foreskins could possibly explain the poor results in smoking patients submitted to foreskin fasciocutaneous flaps in urethral reconstruction surgery.
Authors:
João P Rosado; Luciano A Favorito; Andre G L Cavalcanti; Waldemar S Costa; Luiz E M Cardoso; Francisco J B Sampaio
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International braz j urol : official journal of the Brazilian Society of Urology     Volume:  38     ISSN:  1677-6119     ISO Abbreviation:  Int Braz J Urol     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-09-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158091     Medline TA:  Int Braz J Urol     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  529-35     Citation Subset:  IM    
Affiliation:
Urogenital Research Unit from State University from Rio de Janeiro, RJ, Brazil.
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