| Project/Area Number |
17591661
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Urology
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| Research Institution | Akita University |
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Principal Investigator |
MATSUURA Shinobu Akita University, School of Medicine, Urology, lecturer, 医学部, 講師 (40332465)
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| Co-Investigator(Kenkyū-buntansha) |
SUZUKI Yoshihisa Kyoto University, Graduate School of Medicine, Plastic and Reconstructive Surgery, associate professor, 医学研究科, 助教授 (30243025)
TSUCHIYA Norihiko Akita University, School of Medicine, Urology, associate professor, 医学部, 助教授 (70282176)
HABUCHI Tomonori Akita University, School of Medicine, Urology, professor, 医学部, 教授 (00293861)
成田 伸太郎 秋田大学, 医学部, 助手 (40396552)
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| Project Period (FY) |
2005 – 2006
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| Project Status |
Completed (Fiscal Year 2006)
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| Budget Amount *help |
¥3,700,000 (Direct Cost: ¥3,700,000)
Fiscal Year 2006: ¥1,900,000 (Direct Cost: ¥1,900,000)
Fiscal Year 2005: ¥1,800,000 (Direct Cost: ¥1,800,000)
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| Keywords | cavernous nerve / nerve regeneration / alginate gel / tissue-engineering / radical prostatectomy / neurovascular bundle / 無縫合 / キトサン |
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| Research Abstract |
Erectile dysfunction (ED) remains a major problem in radical prostatectomy. In the era of PSA, prostate cancer was detected at an earlier stage, and patients who underwent the nerve-sparing procedure in a radical prostatectomy concomitantly increased. However, some patients need wide resection of the prostate and the sacrifice of one or both neurovascular bundles (NVB), resulting in postoperative ED. From the viewpoint of cancer control and low quality of life associated with ED, all these patients could be primary candidates for sural nerve autografting for cavernous nerve reconstruction if postoperative erection was desired. A recent animal experiment provided promising data showing that transplantation of a biodegradable conduit combined with a collagen sponge conduit can facilitate regrowth of the excised cavernous nerve. The problems of these grafting procedures are that they require microsurgical suturing to stabilize the nerve stumps to the autologous nerve or the conduit, and m
… More
ay be technically demanding.
We have recently developed a novel alginate gel dressing cross-linked with covalent bonds, which has no inhibitory effect on cell proliferation in vitro, and induces little foreign body reaction when implanted in tissues in vivo.^<1,2> The freeze-dried alginate gel sponge promoted nerve regeneration in cat and rat sciatic nerves^<3,4> and in rat spinal cord.^5 Alginate gel appears to provide neural regeneration more effectively than collagen sponge and fibrin glue.^4 Interestingly, fibroblast migration is much less distinct in alginate implants than in plastic or silicon tubes, implying that alginate gel provides a favorable environment for neural outgrowth by preventing the ingrowth of fibrous scar tissue. Our recent data demonstrated that simply covering the neural gap with an alginate gel sheet can regenerate the excised cavernous nerve of rats, with a success rate of approximately 70% in the mating test at 3 months.^6 In these rats with restored erectile function, electrical stimulation of the MPG suggested functional restoration of the excised cavernous nerve, and a retrograde tracing study addressed this phenomenon.^6 Immunostaining showed the early outgrowth and migration of regenerating axons and Schwann cells from the proximal neural stump of the excised cavernous nerve.^6
Our data indicate that microscopic suturing is not necessarily required for cavernous nerve regeneration if a biodegradable alginate gel sponge sheet placed over the neural gap. The nerve gap can be filled easily and effectively, and this is less invasive for patients and technically less demanding for surgeons if clinically applied. Less
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