Challenges and Perspectives in Male Anterior Urethra Reconstruction Using Tissue Engineering (original) (raw)
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Urethral Reconstruction Using Cell-Based Tissue Engineering Approaches
Urethral reconstruction for complex conditions remains a challenge because of the unsatisfactory long-term results and problems associated with the harvesting of adequate replacement tissues. Tissue engineered substitutes, either scaffolds alone or in combination with cells, can overcome some of the aforementioned problems. Currently, such tissue engineered substitutes have been gaining popularity, as evidenced by >80 published preclinical and 20 clinical studies. This review summarises the currently available literature on the cell-based tissue engineered substitutes (11 studies) for urethral reconstruction. Clinical translational challenges and future directions are also discussed.
Tissue Engineering for Human Urethral Reconstruction: Systematic Review of Recent Literature
PLOS ONE, 2015
Background Techniques to treat urethral stricture and hypospadias are restricted, as substitution of the unhealthy urethra with tissue from other origins (skin, bladder or buccal mucosa) has some limitations. Therefore, alternative sources of tissue for use in urethral reconstructions are considered, such as ex vivo engineered constructs. Purpose To review recent literature on tissue engineering for human urethral reconstruction. Methods A search was made in the PubMed and Embase databases restricted to the last 25 years and the English language.
Frontiers in Pediatrics
Introduction: Tissue engineering is a potential source of urethral substitutes to treat severe urethral defects. Our aim was to create tissue-engineered urethras by harvesting autologous cells obtained by bladder washes and then using these cells to create a neourethra in a chronic large urethral defect in a rabbit model.Methods: A large urethral defect was first created in male New Zealand rabbits by resecting an elliptic defect (70 mm2) in the ventral penile urethra and then letting it settle down as a chronic defect for 5–6 weeks. Urothelial cells were harvested noninvasively by washing the bladder with saline and isolating urothelial cells. Neourethras were created by seeding urothelial cells on a commercially available decellularized intestinal submucosa matrix (Biodesign® Cook-Biotech®). Twenty-two rabbits were divided into three groups. Group-A (n = 2) is a control group (urethral defect unrepaired). Group-B (n = 10) and group-C (n = 10) underwent on-lay urethroplasty, with u...
Annals of Biomedical Engineering, 2017
To evaluate the histological characteristics of decellularized human urethra after transplantation into the rat omentum and compare in vivo cell seeding with perfusionbased and cell sheet urethral regeneration. Eight adult human male urethras accompanied with the surrounding corpus spongiosum were obtained. The tissues were decellularized with detergent-based method. The efficacy of decellularization and extracellular matrix preservation was evaluated by several techniques. Decellularized scaffolds were transplanted into the omentum of 12 male rats and located into the scrotum. Biopsies were taken 1, 3, and 6 months postoperatively to assess the natural recellularization. Mesenchymal stem cells obtained from preputial tissue were seeded with perfusion-based and cell sheet techniques as well. Immunohistochemical staining with a-actin, cytokeratin AE1/AE3, synaptophysin, and CD31 antibodies were performed. Removal of nuclear components and preservation of biomechanical properties was confirmed. In-vivo recellularization revealed promising results in progressive angiogenesis and cell seeding of epithelium-like cells in the lining of the urethra as well as smooth muscle cells in the wall structure. In-vitro urethral regeneration revealed that cell sheet engineering was the technique of choice compared to perfusionbased technique. This study may paw the road for clinical application of acellular urethral matrix with the surrounding corpus spongiosum in urological reconstructive surgery.
Tissue Engineering in Urology- Progress and Prospects - A Review Article
Open Access Journal of Urology & Nephrology
Regenerative medicine is a new branch of medicine based on tissue engineering technology. This field of science has many things to offer in reconstructive urology where native organ is non-functional, and no substitute is available. Despite the initial promising results, it has not become a reality in the true sense. There are numerous obstacles that are slowing down the process of regenerative medicine. The progress shown in stem cell biotechnology and material science provides new vistas to translate experimental methods clinical reality. Tissue engineering encompasses a multidisciplinary approach with the main aim of development of biological substitutes designed to restore and maintain normal function in diseased or injured organs. This review is done to ascertain its current status and the progress that has been made in regenerative medicine in the reconstruction of various Genito-urinary organs.
Bioengineered Scaffolds as Substitutes for Grafts for Urethra Reconstruction
Materials, 2019
Urethral defects originating from congenital malformations, trauma, inflammation or carcinoma still pose a great challenge to modern urology. Recent therapies have failed many times and have not provided the expected results. This negatively affects patients’ quality of life. By combining cells, bioactive molecules, and biomaterials, tissue engineering can provide promising treatment options. This review focused on scaffold systems for urethra reconstruction. We also discussed different technologies, such as electrospinning and 3D bioprinting which provide great possibility for the preparation of a hollow structure with well-defined architecture.
Tissue Engineering of Urinary Bladder and Urethra: Advances from Bench to Patients
The Scientific World Journal, 2013
Urinary tract is subjected to many varieties of pathologies since birth including congenital anomalies, trauma, inflammatory lesions, and malignancy. These diseases necessitate the replacement of involved organs and tissues. Shortage of organ donation, problems of immunosuppression, and complications associated with the use of nonnative tissues have urged clinicians and scientists to investigate new therapies, namely, tissue engineering. Tissue engineering follows principles of cell transplantation, materials science, and engineering. Epithelial and muscle cells can be harvested and used for reconstruction of the engineered grafts. These cells must be delivered in a well-organized and differentiated condition because water-seal epithelium and well-oriented muscle layer are needed for proper function of the substitute tissues. Synthetic or natural scaffolds have been used for engineering lower urinary tract. Harnessing autologous cells to produce their own matrix and form scaffolds is a new strategy for engineering bladder and urethra. This self-assembly technique avoids the biosafety and immunological reactions related to the use of biodegradable scaffolds. Autologous equivalents have already been produced for pigs (bladder) and human (urethra and bladder). The purpose of this paper is to present a review for the existing methods of engineering bladder and urethra and to point toward perspectives for their replacement.
Tissue Engineering in Lower Urinary Tract Reconstruction
2018
Urology diseases and disorders are often diagnosable by special clinical symptoms. Congenital disorders, iatrogenic injuries, inflammatory diseases, infections, tumors, cancers and other conditions of the genitourinary system are in this category. The treatment of these disorders usually involve classical surgeries including organ transplant from deceased or other methods, which are associated with transplant related side effects and complications. Tissue engineering is a rapidly expanding, promising field which addresses tissue and organ failure and organ reconstruction. A myriad of Clinical and preclinical studies have been conducted on different treatment methods and tissue engineering in the field of urology, which have been reviewed in our present study.
Tissue engineering and stem cells: Basic principles and applications in urology
International Journal of Urology, 2010
To overcome problems of damaged urinary tract tissues and complications of current procedures, tissue engineering (TE) techniques and stem cell (SC) research have achieved great progress. Although diversity of techniques is used , urologists should know the basics. We carried out a literature review regarding the basic principles and applications of TE and SC technologies in the genitourinary tract. We carried out MEDLINE/PubMed searches for English articles until March 2010 using a combination of the following keywords: bladder, erectile dysfunction, kidney, prostate, Peyronie's disease, stem cells, stress urinary incontinence, testis, tissue engineering, ureter, urethra and urinary tract. Retrieved abstracts were checked , and full versions of relevant articles were obtained. Scientists have achieved great advances in basic science research. This is obvious by the tremendous increase in the number of publications. We divided this review in two topics; the first discusses basic science principles of TE and SC, whereas the second part delineates current clinical applications and advances in urological literature. TE and SC applications represent an alternative resource for treating complicated urological diseases. Despite the paucity of clinical trials, the promising results of animal models and continuous work represents the hope of treating various urological disorders with this technology.