Sources, Selection, and Microenvironmental Preconditioning of Cells for Urethral Tissue Engineering

Abstract

Urethral stricture is a common urinary tract disorder in men that can be caused by iatrogenic causes, trauma, inflammation, or infection and often requires reconstructive surgery. The current therapeutic approach for complex urethral strictures usually involves reconstruction with autologous tissue from the oral mucosa. With the goal of overcoming the lack of sufficient autologous tissue and donor site morbidity, research over the past two decades has focused on cell-based tissue-engineered substitutes. While the main focus has been on autologous cells from the penile tissue, bladder, and oral cavity, stem cells from sources such as adipose tissue and urine are competing candidates for future urethral regeneration due to their ease of collection, high proliferative capacity, maturation potential, and paracrine function. This review addresses the sources, advantages, and limitations of cells for tissue engineering in the urethra and discusses recent approaches to improve cell survival, growth, and differentiation by mimicking the mechanical and biophysical properties of the extracellular environment.

Trilayer composite scaffold for urethral reconstruction: in vitro evaluation of mechanical, biological, and angiogenic properties

“…Secondly, we focused on human bladder SMCs, which, although relevant for evaluating certain aspects, do not include all cell types involved in urethral reconstruction (e.g. urothelial or endothelial cells) [74]. Future research should therefore aim to address these limitations through in vivo experiments and the inclusion of a broader range of relevant cell types to ultimately allow a more comprehensive assessment of the suitability of the CPC scaffold for urethral reconstruction.…”

Tissue Engineering for Penile Reconstruction

“…However, in long urethral strictures, substituting urethroplasty with genital skin and buccal mucosa grafts is the only option [ 42 ]. The current gold-standard therapeutic approach for complex urethral strictures usually involves reconstruction with autologous tissue from the oral mucosa [ 43 ]. However, surgical procedures are associated with severe complications, such as fistulas, urethral strictures, and dehiscence of the repair or recurrence of chordee [ 44 , 45 ].…”

Adipose stem cells in tissue regeneration and repair: From bench to bedside

“…The advantage of autologous natural materials is that there is no rejection reaction, but the disadvantage is that their biomechanical properties are poor, which can easily lead to scar formation and other complications. But it lacks smooth muscle cells [ 80 ]. Artificial materials have been widely used in tissue engineering.…”