{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T17:54:50Z","timestamp":1780077290247,"version":"3.54.0"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T00:00:00Z","timestamp":1663632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Myofibroblast\u2010dominant proliferation (relative to fibroblast proliferation) is the key process in urethral fibrosis, but its association with clinical features is not understood. We conducted a histological analysis of urethral strictures and examined the association between myofibroblast proliferation and stricture characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Formalin\u2010fixed, paraffin\u2010embedded urethral sections sliced axially from 175 male patients with bulbar urethral strictures were retrospectively analyzed. All patients underwent excision and primary anastomosis between September 2008 and January 2021 by a surgeon (AH). Masson's trichrome stain was used to estimate the area of fibrosis. Corresponding unstained slides with the largest area of fibrosis were selected and double\u2010immunostained with anti\u2010smooth muscle actin (SMA) and anti\u2010TE\u20107 mouse monoclonal antibodies for the assessment of myofibroblasts and fibroblasts, respectively. The ratio of the number of SMA\u2010positive cells to the number of TE\u20107\u2010positive cells (SMA\/TE\u20107 ratio) was calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The area of fibrosis in strictures due to perineal trauma (<jats:italic>n<\/jats:italic>\u2009=\u200985, median 108.9\u2009mm<jats:sup>2<\/jats:sup>) was significantly larger than that in non\u2010traumatic strictures (<jats:italic>n<\/jats:italic>\u2009=\u200990, median 42.9\u2009mm<jats:sup>2<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). The area of fibrosis positively correlated with SMA expression (<jats:italic>r<\/jats:italic>\u2009=\u20090.35, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and the SMA\/TE\u20107 ratio (<jats:italic>r<\/jats:italic>\u2009=\u20090.36, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), but not with TE\u20107 expression (r\u2009=\u2009\u22120.01, <jats:italic>p<\/jats:italic>\u2009=\u20090.75). In a multivariate linear regression model, traumatic etiology (standard coefficient 0.37, <jats:italic>t<\/jats:italic> value 3.9, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and increased SMA expression (standard coefficient 0.17, <jats:italic>t<\/jats:italic> value 2.1, <jats:italic>p<\/jats:italic>\u2009=\u20090.03) were the predictors of wide fibrosis area.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Myofibroblast\u2010dominant proliferation may contribute to the pathogenesis of severe urethral fibrosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iju.15053","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T08:50:51Z","timestamp":1663663851000},"page":"107-112","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Myofibroblast\u2010dominant proliferation associated with severe fibrosis in bulbar urethral strictures"],"prefix":"10.1111","volume":"30","author":[{"given":"Yusuke","family":"Hirano","sequence":"first","affiliation":[{"name":"Department of Urology National Defense Medical College  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7678-6375","authenticated-orcid":false,"given":"Akio","family":"Horiguchi","sequence":"additional","affiliation":[{"name":"Department of Urology National Defense Medical College  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichiro","family":"Ojima","sequence":"additional","affiliation":[{"name":"Department of Urology National Defense Medical College  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuichi","family":"Azuma","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery National Defense Medical College  Saitama 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