Human Acellular Matrix Graft of Tunica Albuginea for Penile Reconstruction


Eloisio Alexsandro da Silva, PhD, Service of Urology, Pedro Ernesto Memorial Hospital, Rio de Janeiro State University, Boulevard 28 de Setembro, 77-5° Andar, Vila Isabel, Rio de Janeiro 20551-030, Brazil. Tel: (55) 2587-6242; Fax: (55) 2587-6242; E-mail:


Introduction.  Penile curvature is one of the most common male conditions, affecting nearly 10% of men, and can impair sexual intercourse. Tunica albuginea (hTA) plays a key role in penile curvature, and reconstructive procedures may be necessary for its substitution. Although several grafts have been proposed for hTA repair, the ideal graft is not yet available.

Aim.  The aim of this article is to evaluate a new human tunica albuginea acellular matrix (hTAAM) as potential graft for penile reconstructive procedures.

Methods.  Twelve penises were obtained during sex reassignment surgeries from male-to-female transsexual patients. After dissection, hTAs were assigned into two groups according to the decellularization methods: polyethylene glycol (PEG) 1000 method following ultraviolet-C radiation, and Triton X-100 modified method.

Main Outcome Measures.  Structural analyses were assessed by hematoxilin and eosin, Masson's trichrome, Weigert's, and picrosirius-polarization staining methods. Total protein, total glycosaminoglycan (GAG), and nucleic acid (DNA and RNA) concentrations were assessed by specific biochemical analyses. Uniaxial strength tests were performed to evaluate biomechanical properties.

Results.  All hTAAMs presented no nuclear or cellular remnants. Total protein concentration was significantly higher in PEG 1000 hTAAM. Despite GAG concentration decreased significantly in hTAAM, Triton X-100 hTAAM retained the highest GAG concentration (1.0 ± 0.42 µg HexUr/mg dry tissue, P > 0.05). All decellularization methods were efficacious to remove nucleic acids. The maximal break point presented no difference between hTA and hTAAM groups (P > 0.05).

Conclusions.  PEG 1000 and Triton X-100 decellularization methods provide equally successful hTAAMs, preserving original structural and biochemical properties. da Silva FG, Filho AM, Damião R, and da Silva EA. Human acellular matrix graft of tunica albuginea for penile reconstruction. J Sex Med 2011;8:3196–3203.