{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T13:19:41Z","timestamp":1769260781737,"version":"3.49.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tunica albuginea plays a critical role in the biomechanics of the penis, as the main bearer of mechanical forces during erection; collagen is central to changes that occur in the tunica of Peyronie\u2019s patients; however, our understanding of tunica collagen composition remains poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To quantify collagen abundance and subtypes in tunica and corpora cavernosa of reconstruction patients treated with 0-25\u00a0years of 17\u03b2-estradiol and Spironolactone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Tunica and corpora cavernosa (n\u2009=\u200925) were obtained from patients undergoing penectomy with reconstruction surgery. Collagen was quantified and evaluated with 17\u03b2-estradiol treatment, age, antiandrogen, and testosterone concentration. Immunohistochemistry (IHC) for collagen I-IV was performed with ImageJ quantification. Primary tunica cell cultures were established and characterized for P4HB (fibroblast), \u03b1-ACTIN (smooth muscle), and CD31 (endothelium). Fibroblast growth with Sonic hedgehog (SHH), BMP4, and GREM1 treatment were quantified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>Hydroxyproline, IHC, and cell culture were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Collagen abundance did not correlate with duration of 17\u03b2-estradiol and antiandrogen treatment, age, and testosterone level. Collagen III was more abundant in the corpora cavernosa than the tunica, and collagen III increased 35.4% (P\u2009=\u2009.05) in tunica of patients treated with 17\u03b2-estradiol and antiandrogen, mimicking the increased collagen III observed in Peyronie\u2019s patients. Collagen I was 12.1% higher in the corpora cavernosa than the tunica (P\u2009=\u2009.049) and was unchanged in tunica (P\u2009=\u2009.34) and corpora cavernosa (P\u2009=\u2009.41) with 17\u03b2-estradiol and antiandrogen treatment. Collagen IV increased 26.6% in corpora cavernosa with 17\u03b2-estradiol and antiandrogen treatment (P\u2009=\u2009.005). P4HB staining fibroblasts were isolated from patient tunica; fibroblasts increased growth with GREM1 and decreased growth with BMP4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Implications<\/jats:title>\n                    <jats:p>Reconstruction patients develop Peyronie\u2019s-like changes in collagen subtypes (collagen III) in the tunica that offer a unique opportunity to study how collagen signaling becomes dysfunctional and provide novel insight into early-stage collagen changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Strengths and Limitations<\/jats:title>\n                    <jats:p>Collagen III increased in tunica of reconstruction patients. It is of interest that tunica of reconstruction patients, which do not display a plaque as in Peyronie\u2019s patients, show a similar change in collagen III abundance. It is unclear how changes in collagen subtype impact erectile function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In addition to 17\u03b2-estradiol and antiandrogen treatment, reconstruction patients practice aggressive taping and compression of their tissue, which may induce Peyronie\u2019s-like collagen changes from the repeated microtrauma and\/or ischemia; reconstruction patient tunica may provide a novel model to study changes in collagen signaling and offer insight into development of Peyronie\u2019s changes in tunica architecture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Statement of Significance<\/jats:title>\n                    <jats:p>Reconstruction patients develop a Peyronie\u2019s like condition with increased collagen III in the tunica, that offers a unique opportunity to study how collagen signaling become dysfunctional and provide novel insight into early stage Peyronie\u2019s collagen changes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdaf387","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T13:01:07Z","timestamp":1766062867000},"source":"Crossref","is-referenced-by-count":0,"title":["Peyronie\u2019s-like changes in the tunica albuginea were identified in reconstruction patients"],"prefix":"10.1093","volume":"23","author":[{"given":"Alberto","family":"Colombo","sequence":"first","affiliation":[{"name":"Department of Urology, University of Illinois at Chicago , Chicago, IL 60612 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiangping","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Illinois at Chicago , Chicago, IL 60612 ,","place":["United 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