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Mechanical characterization of fibrotic and mineralized tissue in Peyronie’s disease

Abstract

Peyronie’s disease affects penile mechanics, but published research lacks biomechanical characterization of affected tunica albuginea. This work aims to establish mechanical testing methodology and characterize pathological tissue mechanics of Peyronie’s disease. Tunica albuginea was obtained from patients (n = 5) undergoing reconstructive surgery for Peyronie’s disease, sectioned into test specimens (n = 12), stored frozen at −20 °C, and imaged with micro-computed tomography (µCT). A tensile testing protocol was developed based on similar soft tissues. Correlation of mechanical summary variables (force, displacement, stiffness, work, Young’s modulus, ultimate tensile stress, strain at ultimate tensile stress, and toughness) and µCT features were assessed with linear regression. Specimens empirically grouped into hard or soft stress–strain behavior were compared using a Student’s t-test. Surface strain and failure patterns were described qualitatively. Specimens displayed high inter- and intra-subject variability. Mineralization volume was not correlated with mechanical parameters. Empirically hard tissue had higher ultimate tensile stress. Failure mechanisms and strain patterns differed between mineralized and non-mineralized specimens. Size, shape, and quantity of mineralization may be more important in determining Peyronie’s disease plaque behavior than presence of mineralization alone, and single summary variables like modulus may not fully describe mechanical behavior.

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Fig. 1: Proposed mechanical testing protocol.
Fig. 2: Pilot data.
Fig. 3: Two-dimensional projections of µCT scans.
Fig. 4: Regression of geometric and material variables.
Fig. 5: Representative soft tissue failure, specimen E3.
Fig. 6: Representative hard tissue failure, specimen C2.

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Acknowledgements

The authors acknowledge assistance with µCT imaging from Prof Timothy Cox at the Small Animal Tomographic Analysis (SANTA) facility, Seattle Children’s Research Institute (now at University of Missouri-Kansas City School of Dentistry), and Dr. Tami Wolden-Hanson of the VA Puget Sound Rodent InVivo Molecular Imaging Core.

Funding

The authors acknowledge funding from the VA Puget Sound graduate student fellowship and VA RR&D Grant RX002970.

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Correspondence to William R. Ledoux.

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Brady, L., Stender, C.J., Wang, YN. et al. Mechanical characterization of fibrotic and mineralized tissue in Peyronie’s disease. Int J Impot Res 34, 477–486 (2022). https://doi.org/10.1038/s41443-021-00439-2

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