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.

Development of a conductive biocomposite combining graphene and amniotic membrane for replacement of the neuronal network of tissue-engineered urinary bladder

“…Regenerative medicine struggles to develop reliable tissue engineering technology for replacing diseased, inured or resected urinary bladders. Despite results indicating the feasibility of smooth muscles and urothelial layer regeneration, reestablishing bladder function emerged as a significant challenge which must be overcome to translate experimental settings into clinics 28 . The replacing of the neural network within the urinary bladder is "terra incognita" of regenerative medicine.…”

Tissue Engineering and Its Potential to Reduce Prostate Cancer Treatment Sequelae—Narrative Review

“…At the beginning of tissue engineering research, the dominant belief was that implanted stem cells locally replace injured tissue by direct differentiation and forming incorporated neotissue. At present, however, we are of the opinion that the regeneration effect is a result of realizing bioactive molecules (6). In particular, paracrine stimulation of angiogenesis is of utmost importance as it is a major profibrotic factor.…”

“…Tissue engineering offers the possibility to overcome limitations of current management for postprostatectomy incontinence and ED. Developed in recent years biotechnological feasibility of mesenchymal stem cell isolation, in vitro cultivation and implantation became the basis for new cell-based therapies oriented to induce regeneration of adult tissue (6). The perspective to offer patients suffering from postprostatectomy incontinence of ED minimal invasive one-time procedure utilizing autologous stem cell transplantation is a tempting idea.…”

Urothelium – the brain of the urinary bladder. Will knowing its properties pave the way for creating a tissue-engineered bladder?

“…The bladder neural plexus fails to regenerate beyond the lesion site and native axons do not elongate into the tissue-engineered graft. In this context, rebuilding the neural network within the neobladder wall should be a high priority [37]. Finding a way to restore proper vascularisation and innervation is the only chance for effective and up-to-date treatment of neurogenic bladder by means of tissue engineering.…”