{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:37:39Z","timestamp":1771807059492,"version":"3.50.1"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T00:00:00Z","timestamp":1638835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:p>The use of autologous tissue grafts for tunica albuginea repair in Peyronie\u2019s disease and congenital chordee is often restricted by limited tissue availability and donor site morbidity, therefore new biomaterial options are needed. In this study, bi-layer silk fibroin (BLSF) scaffolds were investigated to support functional tissue regeneration of tunica albuginea in a rabbit corporoplasty model. Eighteen adult male, New Zealand white rabbits were randomized to nonsurgical controls (NSC, <jats:italic>N<\/jats:italic> = 3), or subjected to corporoplasty with BLSF grafts (<jats:italic>N<\/jats:italic> = 5); decellularized small intestinal submucosa (SIS) matrices (<jats:italic>N<\/jats:italic> = 5); or autologous tunica vaginalis (TV) flaps (<jats:italic>N<\/jats:italic> = 5). End-point evaluations were cavernosography, cavernosometry, histological, immunohistochemical, and histomorphometric assessments. Maximum intracorporal pressures (ICP) following papaverine-induced erection were similar between all groups. Eighty percent of rabbits repaired with BLSF scaffolds or TV flaps achieved full rigid erections, compared to 40% of SIS reconstructed animals. Five-minute peak erections were maintained in 60% of BLSF rabbits, compared to 20% of SIS and TV flap reconstructed rabbits. Graft perforation occurred in 60% of TV group at maximum ICP compared to 20% of BLSF cohort. Neotissues supported by SIS and BLSF scaffolds were composed of collagen type I and elastin fibers similar to NSC. SIS and TV flaps showed significantly elevated levels of corporal fibrosis relative to NSC with a corresponding decrease in corporal smooth muscle cells expressing contractile proteins. BLSF biomaterials represent emerging platforms for corporoplasty and produce superior functional and histological outcomes in comparison to TV flaps and SIS matrices for tunica albuginea repair.<\/jats:p>","DOI":"10.3389\/fbioe.2021.791119","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T11:19:42Z","timestamp":1638875982000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluation of Bi-Layer Silk Fibroin Grafts for Penile Tunica Albuginea Repair in a Rabbit Corporoplasty Model"],"prefix":"10.3389","volume":"9","author":[{"given":"Gokhan","family":"Gundogdu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhamshid","family":"Okhunov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Starek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faith","family":"Veneri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hazem","family":"Orabi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah A.","family":"Holzman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryrose P.","family":"Sullivan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoine E.","family":"Khoury","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua R.","family":"Mauney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1089\/ten.TEA.2018.0113","article-title":"Augmentation Cystoplasty of Diseased Porcine Bladders with Bi-layer Silk Fibroin Grafts","volume":"25","author":"Affas","year":"2019","journal-title":"Tissue Eng. A."},{"key":"B2","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/j.biomaterials.2015.02.092","article-title":"Acellular Bi-layer Silk Fibroin Scaffolds Support Functional Tissue Regeneration in a Rat Model of Onlay Esophagoplasty","volume":"53","author":"Algarrahi","year":"2015","journal-title":"Biomaterials"},{"key":"B3","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1016\/j.jss.2018.04.006","article-title":"Repair of Injured Urethras with Silk Fibroin Scaffolds in a Rabbit Model of Onlay Urethroplasty","volume":"229","author":"Algarrahi","year":"","journal-title":"J. Surg. Res."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e894","DOI":"10.1002\/term.2402","article-title":"Bi\u2010layer Silk Fibroin Grafts Support Functional Tissue Regeneration in a Porcine Model of Onlay Esophagoplasty","volume":"12","author":"Algarrahi","year":"","journal-title":"J. Tissue Eng. Regen. Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1693","DOI":"10.1016\/j.juro.2007.03.166","article-title":"Outcome Analysis of Severe Chordee Correction Using tunica Vaginalis as a Flap in Boys with Proximal Hypospadias","volume":"178","author":"Braga","year":"2007","journal-title":"J. Urol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1064","DOI":"10.1016\/S0022-5347(01)63836-910.1097\/00005392-199803000-00148","article-title":"Comparison of tunica Albuginea Substitutes for the Treatment of Peyronie's Disease","volume":"159","author":"Brannigan","year":"1998","journal-title":"J. Urol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"704","DOI":"10.1111\/bju.12565","article-title":"Outcomes of Surgical Treatment of Peyronie's Disease","volume":"113","author":"Carson","year":"2014","journal-title":"BJU Int."},{"key":"B8","doi-asserted-by":"publisher","first-page":"3346","DOI":"10.1073\/pnas.0909367106","article-title":"Bioengineered Corporal Tissue for Structural and Functional Restoration of the Penis","volume":"107","author":"Chen","year":"2010","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"B9","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1097\/00005392-200107000-00044","article-title":"A Comparison of Dermal and Cadaveric Pericardial Grafts in the Modified Horton-devine Procedure for Peyronie? Disease","volume":"166","author":"Chun","year":"2001","journal-title":"J. Urol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1111\/j.1743-6109.2010.02102.x","article-title":"Five\u2010Year Follow\u2010Up of Peyronie's Graft Surgery: Outcomes and Patient Satisfaction","volume":"8","author":"Chung","year":"2011","journal-title":"J. Sex. Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"7452","DOI":"10.1016\/j.biomaterials.2014.05.044","article-title":"The Use of Bi-layer Silk Fibroin Scaffolds and Small Intestinal Submucosa Matrices to Support Bladder Tissue Regeneration in a Rat Model of Spinal Cord Injury","volume":"35","author":"Chung","year":"","journal-title":"Biomaterials"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e91592","DOI":"10.1371\/journal.pone.0091592","article-title":"Acellular Bi-layer Silk Fibroin Scaffolds Support Tissue Regeneration in a Rabbit Model of Onlay Urethroplasty","volume":"9","author":"Chung","year":"","journal-title":"PLoS One"},{"key":"B13","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1016\/s0090-4295(01)01651-x","article-title":"Treatment of Peyronie's Disease by Incomplete Circumferential Incision of the tunica Albuginea and Plaque with Bovine Pericardium Graft","volume":"59","author":"Egydio","year":"2002","journal-title":"Urology"},{"key":"B14","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1016\/j.cardiores.2003.12.006","article-title":"Aging-related Induction of Inducible Nitric Oxide Synthase Is Vasculo-Protective to the Arterial media","volume":"61","author":"Ferrini","year":"2004","journal-title":"Cardiovasc. Res."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1016\/S0022-5347(05)65802-8","article-title":"Tunica Vaginalis for Correcting Penile Chordee in a Rabbit Model: Is There a Difference in Flap versus Graft?","volume":"166","author":"Hafez","year":"2001","journal-title":"J. Urol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1111\/bju.13604","article-title":"Preliminary Experience Using a tunica Vaginalis Flap as the Dorsal Component of Bracka's Urethroplasty","volume":"119","author":"Harper","year":"2017","journal-title":"BJU Int."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1673","DOI":"10.1097\/01.ju.0000154356.76027.4f","article-title":"Histological Alterations in Cavernous Tissue after Radical Prostatectomy","volume":"173","author":"Iacono","year":"2005","journal-title":"J. Urol."},{"key":"B18","first-page":"264","article-title":"Corporoplasty with Saphenous Venous Patch Graft for Peyronie's Disease","volume":"102","author":"Khope","year":"2004","journal-title":"J. Indian Med. Assoc."},{"key":"B19","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1016\/S0090-4295(02)01607-2","article-title":"Use of Porcine Small Intestinal Submucosal Graft in the Surgical Management of Tunical Deficiencies with Penile Prosthetic Surgery","volume":"59","author":"Knoll","year":"2002","journal-title":"Urology"},{"key":"B20","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1055\/s-0036-1583301","article-title":"Donor-Site Morbidity Following Free Tissue Harvest from the Thigh: A Systematic Review and Pooled Analysis of Complications","volume":"32","author":"Lakhiani","year":"2016","journal-title":"J. Reconstr. Microsurg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1046\/j.1464-410x.2003.04279.x","article-title":"Comparison of Cadaveric Pericardial, Dermal, Vein, and Synthetic Grafts for tunica Albuginea Substitution Using a Rat Model","volume":"92","author":"Leungwattanakij","year":"2003","journal-title":"BJU Int."},{"key":"B22","doi-asserted-by":"publisher","first-page":"693e1","DOI":"10.1016\/j.jpurol.2013.04.021","article-title":"Two-stage Complex Hypospadias Repair when Urethral Plate Has to Be Divided: Ventral Corporoplasty Using a tunica Vaginalis Flap","volume":"9","author":"Macedo","year":"2013","journal-title":"J. Pediatr. Urol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"826","DOI":"10.1097\/00005392-199503000-00082","article-title":"Investigative Urology","volume":"153","author":"Moreland","year":"1995","journal-title":"J. Urol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1097\/00005392-199909010-00089","article-title":"Transforming Growth Factor-Beta 1 (TGF-Beta 1 ) Is Sufficient to Induce Fibrosis of Rabbit Corpus Cavernosum In Vivo","volume":"162","author":"Nehra","year":"1999","journal-title":"J. Urol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1111\/j.1464-410X.2008.08343.x","article-title":"Severe Penile Injuries: a Problem of Severity and Reconstruction","volume":"104","author":"Perovic","year":"2009","journal-title":"BJU Int."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1097\/01.ju.0000083694.44384.39","article-title":"Successful Use of tunica Vaginalis Grafts for Treatment of Severe Penile Chordee in Children","volume":"170","author":"Ritchey","year":"2003","journal-title":"J. Urol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1007\/s11934-015-0567-x","article-title":"Silk Fibroin Scaffolds for Urologic Tissue Engineering","volume":"17","author":"Sack","year":"2016","journal-title":"Curr. Urol. Rep."},{"key":"B28","doi-asserted-by":"publisher","first-page":"4758","DOI":"10.1016\/j.biomaterials.2013.03.038","article-title":"The Performance of Silk Scaffolds in a Rat Model of Augmentation Cystoplasty","volume":"34","author":"Seth","year":"2013","journal-title":"Biomaterials"},{"key":"B29","doi-asserted-by":"publisher","first-page":"15771578","DOI":"10.1097\/01.ju.0000083802.87337.af","article-title":"Complications of Small Intestinal Submucosa for Corporal Body Grafting for Proximal Hypospadias","volume":"170","author":"Soergel","year":"2003","journal-title":"J. Urol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1002\/(sici)1097-4644(19971215)67:4<478::aid-jcb6>3.0.co;2-p","article-title":"Identification of Extractable Growth Factors from Small Intestinal Submucosa","volume":"67","author":"Voytik-Harbin","year":"1997","journal-title":"J. Cel. Biochem."},{"key":"B31","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1046\/j.1464-410x.2002.02808.x","article-title":"Tunica Albuginea Acellular Matrix Graft for Penile Reconstruction in the Rabbit: a Model for Treating Peyronie's Disease","volume":"90","author":"Wefer","year":"2002","journal-title":"BJU Int."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1593","DOI":"10.1097\/01.ju.0000083863.01634.e1","article-title":"Single Layered Small Intestinal Submucosa in the Repair of Severe Chordee and Complicated Hypospadias","volume":"170","author":"Weiser","year":"2003","journal-title":"J. Urol."}],"container-title":["Frontiers in Bioengineering and Biotechnology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2021.791119\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T11:19:46Z","timestamp":1638875986000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2021.791119\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,7]]},"references-count":32,"alternative-id":["10.3389\/fbioe.2021.791119"],"URL":"https:\/\/doi.org\/10.3389\/fbioe.2021.791119","relation":{},"ISSN":["2296-4185"],"issn-type":[{"value":"2296-4185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,7]]},"article-number":"791119"}}