Advancements in Urethral Reconstruction Using Biodegradable Tissue: A Comprehensive Review
Main Article Content
Abstract
Urethral reconstruction, a pivotal domain within the realm of urology, has undergone a transformative evolution with the advent of innovative strategies utilizing biodegradable tissue. This article presents a comprehensive exploration of the burgeoning field of Urethral Reconstruction with Biodegradable Tissue (URBT), shedding light on its intricate nuances and clinical implications.
The utilization of biodegradable materials in urethral reconstruction represents a paradigm shift aimed at circumventing the limitations inherent in traditional non-biodegradable approaches. The inherent ability of these materials to provide temporary structural support during the critical phases of tissue healing, coupled with subsequent degradation, obviates the need for secondary interventions for material removal, thus mitigating the risk of complications associated with prolonged foreign body presence.
This review scrutinizes the biomechanical properties of various biodegradable scaffolds, examining their capacity to withstand physiological stresses while fostering optimal tissue regeneration. Immunological responses to these materials are also elucidated, providing insights into the biocompatibility and host reactions critical for long-term success. Furthermore, the nuanced kinetics of biodegradation are explored, emphasizing their impact on the temporal dynamics of tissue healing and functional restoration.
Delineating the clinical applicability of diverse biodegradable constructs, ranging from synthetic polymers to naturally-derived matrices, constitutes a focal point of this analysis. The article critically evaluates the outcomes and complications associated with URBT, providing a comprehensive understanding of the efficacy and challenges inherent in this emerging field.
As the landscape of urological surgery continues to evolve, this article serves as a beacon for clinicians, researchers, and medical practitioners navigating the complexities of urethral reconstruction. By delving into the molecular intricacies and clinical implications of URBT, it aims to contribute substantively to the ongoing discourse that shapes the future trajectory of urological surgery, offering a roadmap towards optimized patient outcomes and improved quality of life.
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References
I. Mundy AR, Andrich DE. Urethral trauma. Part I: introduction, history, anatomy, pathology, assessment and emergency management. BJU Int. 2011;108(3):310 327. 10.1111/j.1464-410X.2011.10339.x)
II. Santucci RA, Joyce GF, Wise M. Male urethral stricture disease. J Urol. 2007;177(5):1667 1674. 10.1016/j.juro.2007.01.041)
III. Lumen N, Campos-Juanatey F, Greenwell T.et al. European Association of Urology guidelines on urethral stricture disease (Part 1): management of male urethral stricture disease. Eur Urol 08. 2021;80(2):190 200. 10.1016/j.eururo.2021.05.022)
IV. Campos-Juanatey F, Osman NI, Greenwell T.et al. European Association of Urology guidelines on urethral stricture disease (Part 2): diagnosis, perioperative management, and follow-up in males. Eur Urol 08. 2021;80(2):201 212. 10.1016/j.eururo.2021.05.032)
V. Ekerhult TO, Lindqvist K, Peeker R, Grenabo L. Outcomes of reintervention after failed urethroplasty. Scand J Urol. 2017;51(1):68 72. 10.1080/21681805.2016.1264995)
VI. Saad S, Osman NI, Chapple CR. Tissue engineering: recent advances and review of clinical outcome for urethral strictures. Curr Opin Urol. 2021;31(5):498 503. 10.1097/MOU.0000000000000921)
VII. Kanematsu A. Regenerative medicine for urological tissues: updated review 2018. Int J Urol 2018;25(9):788 791. 10.1111/iju.13762)
VIII. Albersheim J, Smith DW, Pariser JJ, Dahm P. The reporting quality of randomized controlled trials and experimental animal studies for urethroplasty. World J Urol. 2021;39(7):2677 2683. 10.1007/s00345-020-03501-8)
IX. Atala A, Danilevskiy M, Lyundup A.et al. The potential role of tissue-engineered urethral substitution: clinical and preclinical studies. J Tissue Eng Regen Med. 2017;11(1):3 19. 10.1002/term.2112)
X. Versteegden LRM, de Jonge PKJD, IntHout J.et al. Tissue engineering of the urethra: a systematic review and meta-analysis of preclinical and clinical studies. Eur Urol. 2017;72(4):594 606. 10.1016/j.eururo.2017.03.026)
XI. Atala A. Tissue engineering for the replacement of organ function in the genitourinary system. Am J Transplant. 2004;4(suppl 6):58 73. 10.1111/j.1600-6135.2004.0346.x)
XII. Pederzoli F, Joice G, Salonia A, Bivalacqua TJ, Sopko NA. Regenerative and engineered options for urethroplasty. Nat Rev Urol. 2019;16(8):453 464. 10.1038/s41585-019-0198-y)
XIII. el-Kassaby A, AbouShwareb T, Atala A. Randomized comparative study between buccal mucosal and acellular bladder matrix grafts in complex anterior urethral strictures. J Urol. 2008;179(4):1432 1436. 10.1016/j.juro.2007.11.101)
XIV. El-Kassaby AW, Retik AB, Yoo JJ, Atala A. Urethral stricture repair with an off-the-shelf collagen matrix. J Urol. 2003;169(1):170 173. 10.1097/01.ju.0000040520.75572.54)