Dynamic Penile Cavernosa Reconstruction Using Bilateral Innervated Gracilis Muscle: A Preclinical Investigation.

METHODS: Mongrel female dogs (17.4±2.2 kg) were assigned to control (n=3) and treatment group (n=11). Bilateral gracilis muscles were dissected and detached from proximal and distal insertions with neurovascular pedicles, and transferred to pubic area as bilateral cavernosa. The urethra was reconstructed by scrolling the skin attached to the left gracilis flap. The outer layer of the penis was formed by an abdominal flap, with the anterior rectus fascia as the tunica albuginea (Figure 1). The animals were reanesthetized 7 months postoperatively. The dimension and stiffness of the reconstructed penises at rest or erection were measured by electrostimulation on the nerve respectively, and the muscular fatigue-resistant curve (MFRC) was obtained. The canines were then euthanized, and the reconstructed penises were harvested and examined by hematoxylin-eosin, Masson trichrome, Sirius red, and immunohistochemistry staining.