Sensory Innervation of Normal and Hypospadiac Prepuce: Possible Implications in Hypospadiology

Overview

Journal Pediatr Surg Int

Specialties General Surgery
Pediatrics

Date 2004 Sep 28

PMID 15449086

Citations 5

Authors

Zafar Nazir

Rehan Masood

Resham Rehman

Affiliations

Soon will be listed here.

Abstract

Sensory innervation of the skin influences wound healing through the release of neuropeptides from the nerve endings. The purpose of this study was to investigate the differences in the sensory innervation of the normal and the hypospadiac prepuce. The prepuce from 10 healthy children undergoing routine circumcision and 10 age-matched children undergoing hypospadias repair were submitted for immunohistochemistry, using antibodies against protein gene product (PGP) 9.5, calcitonin gene-related peptide (CGRP), and substance P (SP). The hypospadiac prepuce was found to be hypo-innervated for PGP 9.5 and CGRP positive nerves when compared with the normal prepuce ( p<0.05). The number of SP-positive nerves were increased in the hypospadiac prepuce, but not to statistical significance ( p=0.06, confidence interval >95%). There may be differences in the sensory innervation of the normal and hypospadiac prepuce. These differences in tissue environment may partly explain the postoperative edema, poor wound healing leading to urethrocutaneous fistula (UF), and increased analgesia requirements in patients undergoing hypospadias surgery.

Citing Articles

Understanding the Endocrine and Molecular Signaling Cascade Regulation Pathways in Children with Hypospadias.

Bangalore R, Asthana S, R R, Kumar Saini D, Alladi A J Pediatr Genet. 2024; 13(4):300-307.

PMID: 39502853 PMC: 11534462. DOI: 10.1055/s-0044-1787670.

Does local injection of long acting corticosteroid improve postoperative outcome of hypospadias repair? A randomized controlled trial.

Abozamel A, Rammah A, Abdelwahed M, Mostafa A, Abdelaziz A Int Urol Nephrol. 2023; 56(1):9-15.

PMID: 37702895 PMC: 10776459. DOI: 10.1007/s11255-023-03730-x.

Development of the human prepuce and its innervation.

Cunha G, Sinclair A, Cao M, Baskin L Differentiation. 2019; 111:22-40.

PMID: 31654825 PMC: 6936222. DOI: 10.1016/j.diff.2019.10.002.

Reasons for delayed orchiopexies in a korean tertiary care hospital.

Ahn H, Lee H, Park K, Choi H Korean J Urol. 2014; 55(1):69-73.

PMID: 24466401 PMC: 3897634. DOI: 10.4111/kju.2014.55.1.69.

Acute postoperative complications of hypospadias repair.

Bhat A, Mandal A Indian J Urol. 2009; 24(2):241-8.

PMID: 19468404 PMC: 2684260. DOI: 10.4103/0970-1591.40622.

References

Reilly D, Ferdinando D, Johnston C, Shaw C, Buchanan K, Green M . The epidermal nerve fibre network: characterization of nerve fibres in human skin by confocal microscopy and assessment of racial variations. Br J Dermatol. 1997; 137(2):163-70. DOI: 10.1046/j.1365-2133.1997.18001893.x. View

Kahler C, Bellmann R, Reinisch N, Schratzberger P, Gruber B, Wiedermann C . Stimulation of human skin fibroblast migration by the neuropeptide secretoneurin. Eur J Pharmacol. 1996; 304(1-3):135-9. DOI: 10.1016/0014-2999(96)00135-5. View

Baskin L, Erol A, Li Y, Cunha G . Anatomical studies of hypospadias. J Urol. 1998; 160(3 Pt 2):1108-15; discussion 1137. DOI: 10.1097/00005392-199809020-00039. View

Baskin L, Lee Y, Cunha G . Neuroanatomical ontogeny of the human fetal penis. Br J Urol. 1997; 79(4):628-40. DOI: 10.1046/j.1464-410x.1997.00119.x. View

Misery L . Skin, immunity and the nervous system. Br J Dermatol. 1998; 137(6):843-50. View

Smith E, Cohen C, Petros J, Woodard J, Galloway N . Epidermal growth factor (EGF) and EGF receptor in hypospadias. Br J Urol. 1997; 79(1):116-9. DOI: 10.1046/j.1464-410x.1997.22624.x. View

Engin C, Demirkan F, Ayhan S, Atabay K, Baran N . Delayed effect of denervation on wound contraction in rat skin. Plast Reconstr Surg. 1996; 98(6):1063-7. DOI: 10.1097/00006534-199611000-00021. View

Gunter J, Forestner J, Manley C . Caudal epidural anesthesia reduces blood loss during hypospadias repair. J Urol. 1990; 144(2 Pt 2):517-9; discussion 530. View

Onuoha G, Alpar E . Levels of vasodilators (SP, CGRP) and vasoconstrictor (NPY) peptides in early human burns. Eur J Clin Invest. 2001; 31(3):253-7. DOI: 10.1046/j.1365-2362.2001.00787.x. View

10.

Gherardini G, Lundeberg T, Cui J, Eriksson S, Trubek S, Linderoth B . Spinal cord stimulation improves survival in ischemic skin flaps: an experimental study of the possible mediation by calcitonin gene-related peptide. Plast Reconstr Surg. 1999; 103(4):1221-8. DOI: 10.1097/00006534-199904040-00018. View

11.

Senapati A, Anand P, McGregor G, Ghatei M, Thompson R, Bloom S . Depletion of neuropeptides during wound healing in rat skin. Neurosci Lett. 1986; 71(1):101-5. DOI: 10.1016/0304-3940(86)90264-8. View

12.

Sawynok J . Topical and peripherally acting analgesics. Pharmacol Rev. 2003; 55(1):1-20. DOI: 10.1124/pr.55.1.1. View

13.

Waterman B, Renschler T, Cartwright P, Snow B, deVries C . Variables in successful repair of urethrocutaneous fistula after hypospadias surgery. J Urol. 2002; 168(2):726-30; discussion 729-30. View

14.

Richards A, Floyd D, Terenghi G, McGrouther D . Cellular changes in denervated tissue during wound healing in a rat model. Br J Dermatol. 1999; 140(6):1093-9. DOI: 10.1046/j.1365-2133.1999.02908.x. View

15.

Wallengren J, Chen D, Sundler F . Neuropeptide-containing C-fibres and wound healing in rat skin. Neither capsaicin nor peripheral neurotomy affect the rate of healing. Br J Dermatol. 1999; 140(3):400-8. DOI: 10.1046/j.1365-2133.1999.02699.x. View

16.

Szallasi A, Blumberg P . Vanilloid (Capsaicin) receptors and mechanisms. Pharmacol Rev. 1999; 51(2):159-212. View

17.

Onuoha G . Circulating sensory peptide levels within 24 h of human bone fracture. Peptides. 2001; 22(7):1107-10. DOI: 10.1016/s0196-9781(01)00434-x. View

18.

Lai X, Wang Z, Wei L, Wang L . Effect of substance P released from peripheral nerve ending on endogenous expression of epidermal growth factor and its receptor in wound healing. Chin J Traumatol. 2002; 5(3):176-9. View

19.

Severini C, Improta G, Salvadori S, Erspamer V . The tachykinin peptide family. Pharmacol Rev. 2002; 54(2):285-322. DOI: 10.1124/pr.54.2.285. View

20.

Engin C . Effects of calcitonin gene-related peptide on wound contraction in denervated and normal rat skin: a preliminary report. Plast Reconstr Surg. 1998; 101(7):1887-90. DOI: 10.1097/00006534-199806000-00017. View