The effect of platelet rich fibrin on growth factor levels in urethral repair

Abstract

Aim: Platelet rich fibrin (PRF) is an autologous source of growth factors and promotes wound healing. An experimental study was performed to evaluate the effect of PRF on growth factor levels in urethral repair. Materials and Methods: Eighteen Wistar albino rats were included in the study. Rats were allocated in three groups (n:6): control (CG), sham (SG), and PRF (PRFG). In SG, a 5 mm vertical incision was performed in the penile urethra and repaired with 10/0 Vicryl (R) under a microscope. In PRFG, during the urethral repair as described in SG, 1 cc of blood was sampled from each rat and centrifuged for 10 minutes at 2400 rpm. PRF obtained from the centrifugation was placed on the repair site during closure. Penile urethras were sampled 24 hours after PRF application in PRFG and after urethral repair in SG. Transforming growth factor beta receptor (TGF-beta-R-CD105), vascular endothelial growth factor (VEGF) and its receptor (VEGF-R), as well as endothelial growth factor receptor (EGFR), were evaluated in subepithelia of the penile skin and urethra. Groups were compared for growth factor levels and growth factor receptor expression with the Kruskal Wallis test. Results: TGF-beta-R levels were significantly decreased in SG when compared to CG (p < 0.05). In PRFG, TGF-beta-R was increased in both subepithelia of penile skin and urethra with respect to SG (p < 0.05). When VEGF levels and its receptor expression were compared between SG and PRFG, VEGF levels were found to be increased in penile skin subepithelium, whereas VEGF-R expressions were decreased in urethral subepithelia in PRFG (p < 0.05). There was no difference between groups for EGFR levels (p > 0.05). Conclusion: Use of PRF after urethral repair increases TGF-beta-R and VEGF expressions in urethral tissue. PRF can be considered as an alternative measure to improve the success of urethral repair. (C) 2013 Elsevier Inc. All rights reserved.