Reconstructive urology and tissue engineering: Converging developmental paths

Abstract

Reconstructive urology is a complex and demanding branch of modern urology. Complicated cases, necessity of microsurgical approach, and constant exposure to urine make urinary reconstruction especially difficult. With impaired healing, excessive scarring, and recurring fibrosis, functional results are still not satisfying. For better, more successful outcomes, a novel tissue engineering technology-based solutions are being gradually investigated. The use of tissue engineering is the most promising strategy to improve results of reconstructive urology procedures due to possibility of designing organ-specific grafts. Moreover, targeted modification of healing environment by stem cells and growth factors is a unique opportunity that might bring reconstructive urology on molecular level. This review defined limitations and problems encountered in reconstructive urology and discussed relevant tissue engineering-based achievements in the field of urethra, urinary bladder, and ureter regeneration. The background justifying tissue engineering approach to urethra, urinary bladder, and ureter reconstruction was discussed. Then, the wide range of experimental methods utilising biomaterials and cell seeding was deliberated to show readers the current tools offered by tissue engineering. At the end, we characterised major challenges that are needed to be addressed before tissue entering would become standard technology in urological departments.

Keywords: acellular matrix; graft; growth factors; reconstructive urology; scaffold; stem cells; tissue engineering.