Artificial urinary conduit construction using tissue engineering methods

Abstract

Introduction Incontinent urinary diversion using an ileal conduit is the most popular method used by urologists after bladder cystectomy resulting from muscle invasive bladder cancer. The use of gastrointestinal tissue is related to a series of complications with the necessity of surgical procedure extension which increases the time of surgery. Regenerative medicine together with tissue engineering techniques gives hope for artificial urinary conduit construction de novo without affecting the ileum. Material and methods In this review we analyzed history of urinary diversion together with current attempts in urinary conduit construction using tissue engineering methods. Based on literature and our own experience we presented future perspectives related to the artificial urinary conduit construction. Results A small number of papers in the field of tissue engineered urinary conduit construction indicates that this topic requires more attention. Three main factors can be distinguished to resolve this topic: proper scaffold construction along with proper regeneration of both the urothelium and smooth muscle layers. Conclusions Artificial urinary conduit has a great chance to become the first commercially available product in urology constructed by regenerative medicine methods.

Novel surgical techniques, regenerative medicine, tissue engineering and innovative immunosuppression in kidney transplantation

“…All of this means that stem cells, for the restoration of renal function, are likely to feature more prominently in short-term developments as opposed to the implementation of novel BAK systems [ 90 – 92 ]. This is a conclusion borne out by the existing published data, analyses of current studies and general sentiment, not to mention the growing number of stem cell procedures being performed in other medical fields [ 93 – 96 ].…”

Reconstructive urology and tissue engineering: Converging developmental paths

“…Major research efforts are focused on obtaining regenerated urinary bladders, but tissue engineering might offer a more plausible option. The first product obtained from the tissue engineering industry might be translation of artificial urinary conduit biomaterial into reconstructive urology (Kloskowski, Pokrywczyńska, & Drewa, ). In this approach, the biomaterial's characteristic needs to mimic the biomechanics of the intestine wall and provide a suitable surface for urothelial and SMCs.…”

Concise Review: Tissue Engineering of Urinary Bladder; We Still Have a Long Way to Go?

“…Nevertheless, creation of tissue engineering based on continent urinary diversion is still a visionary project. Thus, a more plausible option might be the introduction of an artificial urinary conduit as a first available product in urology obtained from the tissue engineering industry . This solution offers the ability to largely reduce the severity of urinary tract reconstruction after cystectomy and would certainly present a favorable treatment option for a number of patients from different age groups.…”

“…Cells seeded on a scaffold facing toward to the bladder lumen are directly exposed to stored urine, especially those located within inner biomaterial surface . Urine is rich in cationic substances, protamine sulfate and low molecular weight products that are mainly responsible for its high and nonselective cytotoxicity.…”

“…Nevertheless, we need to take into account that the urinary bladder's standard mechanical properties are resultant of passive and active behavior, and dynamic changes during the emptying and filling phase. Designing and fabricating biomaterial which could mimic these sophisticated biomechanical properties is limited by available technology . Alternatively, the mechanical properties of the bowel wall which are applied during reconstructive urology as a gold standard can be considered as a starting point for ongoing research.…”