Urethral reconstruction for complex conditions remains a challenge because of the unsatisfactory long-term results and problems associated with the harvesting of adequate replacement tissues. Tissue engineered substitutes, either scaffolds alone or in combination with cells, can overcome some of the aforementioned problems. Currently, such tissue engineered substitutes have been gaining popularity, as evidenced by >80 published preclinical and 20 clinical studies. This review summarises the currently available literature on the cell-based tissue engineered substitutes (11 studies) for urethral reconstruction. Clinical translational challenges and future directions are also discussed.

Anterior urethral strictures affect the male urethra between the tip of the penis and the apex of the prostate. These form the bulk of urethral strictures in men. The common causes for urethral strictures seem to be idiopathic or related to instrumentation of the urethra. Clinically, patients have varying obstructive symptoms associated with the progressive narrowing of the urethral lumen. Treatment modalities have aimed at incising or excising the fibrous tissue, augmenting the damaged area by grafts or flaps, or more recently, replacing the area with tissue engineered constructs. As the biology of wound healing and fibrous tissue formation is not yet completely understood, urethral strictures continue to pose a challenge to clinicians and scientists.