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Review
. 2019 May 22;16(4):365-384.
doi: 10.1007/s13770-019-00193-z. eCollection 2019 Aug.

Overview of Urethral Reconstruction by Tissue Engineering: Current Strategies, Clinical Status and Future Direction

Zahra Rashidbenam  1 , Mohd Hafidzul Jasman  2 , Pezhman Hafez  3 , Guan Hee Tan  2 , Eng Hong Goh  2 , Xeng Inn Fam  2 , Christopher Chee Kong Ho  4 , Zulkifli Md Zainuddin  2 , Reynu Rajan  5 , Fatimah Mohd Nor  6 , Mohamad Aznan Shuhaili  5 , Nik Ritza Kosai  5 , Farrah Hani Imran  6 , Min Hwei Ng  1
Affiliations
Review

Overview of Urethral Reconstruction by Tissue Engineering: Current Strategies, Clinical Status and Future Direction

Zahra Rashidbenam et al. Tissue Eng Regen Med. .

Abstract

Background: Urinary tract is subjected to a variety of disorders such as urethral stricture, which often develops as a result of scarring process. Urethral stricture can be treated by urethral dilation and urethrotomy; but in cases of long urethral strictures, substitution urethroplasty with genital skin and buccal mucosa grafts is the only option. However a number of complications such as infection as a result of hair growth in neo-urethra, and stone formation restrict the application of those grafts. Therefore, tissue engineering techniques recently emerged as an alternative approach, aiming to overcome those restrictions. The aim of this review is to provide a comprehensive coverage on the strategies employed and the translational status of urethral tissue engineering over the past years and to propose a combinatory strategy for the future of urethral tissue engineering.

Methods: Data collection was based on the key articles published in English language in years between 2006 and 2018 using the searching terms of urethral stricture and tissue engineering on PubMed database.

Results: Differentiation of mesenchymal stem cells into urothelial and smooth muscle cells to be used for urologic application does not offer any advantage over autologous urothelial and smooth muscle cells. Among studied scaffolds, synthetic scaffolds with proper porosity and mechanical strength is the best option to be used for urethral tissue engineering.

Conclusion: Hypoxia-preconditioned mesenchymal stem cells in combination with autologous cells seeded on a pre-vascularized synthetic and biodegradable scaffold can be said to be the best combinatory strategy in engineering of human urethra.

Keywords: Scaffold; Tissue engineering; Urethral reconstruction; Urethral stricture.

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Conflict of interest statement

Conflict of interestThe authors declare that there are no financial conflicts of interest regarding the publication of this paper.

Figures

Fig. 1
Fig. 1
A Onlay substitution urethroplasty, B tubularized substitution urethroplasty
Fig. 2
Fig. 2
A schematic view of proposed combinatory strategy for engineering human urethra in future
See this image and copyright information in PMC

References

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