Fig. 5: Creation of porcine SUI model and urethral pressures following repair of urethral sphincter lesion with PEP.

A Study timeline. B Schematic of cystoscopic induced transurethral full thickness, focal urethral sphincter defect to create the porcine SUI model. Note the apposition of the urethral sphincter muscle to the anterior surface of the vagina and urethra (top image). C Schematic of gross appearance of the urethral sphincter defect at day 0, prior to injecting the intervention (Day 7), and prior to euthanasia (Day 42). D Modified Medspira mCompass pressure catheter highlighting stabilization of the catheter at the bladder neck (gray) and movable pressure sensor (green) used to obtain pressures along the length of the pig’s vagina and urethra. E Scanning electron microscopy of collagen (Top) and collagen reconstituted with 1 × 10¹² exosomes/mL PEP (Bottom). Scale = 1 µm. F Collagen release assay to show sustained exosome release (n = 3). G Representative cystoscopic images of the urethral sphincter lesion on day 7 prior to delivering the intervention and on day 42 prior to euthanasia. Arrows point to the site of the urethral sphincter defect. H Graph of mean urethral pressures pre- and post-injury on day 0 (n = 10), pre-injection on day 7 (n = 10) and prior to euthanasia on day 42. Collagen = injection of collagen; PEP = injection of collagen reconstituted with 1 × 10¹² exosomes/mL PEP. D42 Control = urethral sphincter defect treated with collagen (n = 4); Day 42 PEP = urethral sphincter defect treated with collagen reconstituted with 1 × 10¹² exosomes/mL PEP (n = 6). Bar graph data represents AVE ± SEM, while box-plot data represents the IQR (gray box) and whiskers represent 1.5 IQR. One way ANOVA with post-hoc Tukey HSD was utilized.