Does penile tourniquet application alter bacterial adhesion to rat urethral cells: an in vitro study

J Pediatr Surg. 2018 Apr;53(4):818-824. doi: 10.1016/j.jpedsurg.2017.06.018. Epub 2017 Jun 28.


Purpose: To investigate the effects of penile tourniquet (PT) application on bacterial adhesion to urothelium.

Methods: Fifty-six rats were allocated into control group (CG), sham group (SG), PT group (PTG). No intervention was applied in CG. A 5mm-length urethral repair was performed in SG and PTG. In PTG, a 10-min duration of PT was applied during the procedure and the tissue oxygenation monitor was used to adjust the same degree of ischemia in all subjects. Samples were examined for wound healing parameters and tissue levels of inflammatory markers, eNOS, e-selectin, and ICAM-1antibodies. The adhesion of Escherichia coli to urothelium was investigated with in vitro adhesion assay.

Results: Inflammation was higher and wound healing was worse in SG than CG and in PTG in comparison to CG and SG (p<0.05). The endothelial damage, as shown by eNOS expression, was significantly higher in PTG compared to CG and SG (p<0.05). The staining with ICAM-1 and e-selectin antibodies, showing increased inflammatory response to bacterial adhesion, was significantly higher in PTG compared to CG and SG (p<0.05). In vitro urethral cell proliferation was achieved only in CG and SG revealing significantly increased adhesion in SG compared to CG (p<0.05). The PT application caused endothelial corruption and prevented cell proliferation in cell culture.

Conclusion: The PT application does not improve wound healing and increases bacterial adhesion molecules in penile tissue. The in vitro assays showed that PT causes severe endothelial damage and inhibits endothelial cell proliferation.

Keywords: Bacterial adhesion; Electron microscopy; In vitro; Penile tourniquet.

MeSH terms

  • Animals
  • Bacterial Adhesion*
  • Biomarkers / metabolism
  • Escherichia coli / physiology*
  • Male
  • Penis / microbiology*
  • Rats
  • Rats, Wistar
  • Tourniquets*
  • Urethra / metabolism
  • Urethra / microbiology*
  • Urethra / surgery
  • Wound Healing / physiology


  • Biomarkers