Accepted for/Published in: JMIR Research Protocols
Date Submitted: Dec 14, 2024
Date Accepted: Jan 24, 2025
Comparative Histopathological Analysis and COL1A1, COL3A1, and ELN Expression between Proximal and Distal Ventral Dartos of Hypospadias Patients: A Protocol for a Prospective Case-Control Study
ABSTRACT
Background:
The exact cause of penile curvature in hypospadias remains unknown. Resection of the dartos fascia has been observed to straighten the penis, indicating the involvement of the dartos fascia in superficial chordee. However, the characteristics of dartos tissue in the distal territory of the ventral penile shaft may differ from those in the proximal aspect of the penile shaft.
Objective:
To investigate the distinct histopathological profiles and expression of COL1A1 (collagen type 1), COL3A1 (collagen type 3), and ELN (elastin) in proximal and distal ventral dartos of hypospadias patients compared to those with normal penis.
Methods:
This prospective case-control study compares the ventral dartos tissue of hypospadias patients at different locations with that of normal patients. Dartos samples will be taken during surgery, with age matching. Histopathology examination uses hematoxylin and eosin (H&E) and Masson's trichrome stain. The messenger ribonucleic acid (mRNA) expression of COL1A1, COL3A1, and ELN will be quantified using a two-step reverse transcription-polymerase chain reaction (RT-PCR) analysis.
Results:
Previous studies have documented different characteristics of dartos tissue between hypospadias and normal patients. Some studies even suggest resection of the dartos tissue during hypospadias repair. However, this is the first study to compare the characteristics of ventral dartos tissue in hypospadias patients based on its location along the penile shaft, suggesting potential differences between the distal and proximal locations.
Conclusions:
Differences in the characteristics of dartos fascia based on its location may require tailored surgical strategies. If the properties of distal dartos tissue closely mirror those of typical dartos tissue, the possibility of avoiding its excision during hypospadias surgery could be considered.
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