Ureteral Reconstruction: Small Intestine Submucosa for the Management of Strictures and Defects of the Upper Third of the Ureter

Abstract

The use of small intestine submucosa is a novel, effective material for the scaffolding of ureteral defects and/or strictures of the upper ureteral segment in the pig model.

Bladder augmentation using acellular collagen biomatrix: a pilot experience in exstrophic patients

“…Regeneration of the bladder wall components was attempted in recent years, adopting in vitro or in vivo strategies, in animal models [5,6,17,[19][20][21] and seldom in humans [12][13][14][15][16]22]. In vitro engineered bladders for cystoplasty have been constructed, using collagen scaffolds seeded with autologous urothelial and muscle cells [6,16,19].…”

“…We adopted the SIS membrane as acellular biomatrix to stimulate bladder tissue regeneration, as extensively experimented in animal models (rats [6], rabbits [19], dogs [21] and pigs [5,17]) and used in several indications in humans without adverse effects [11][12][13][14][15]. SIS is a xenogenic membrane, harvested from pig small intestine submucosa, acellular or with very few and non-influent nuclei, non-immunogenic.…”

“…At present, two decellularized xenogenic or allogenic biomaterials, porcine small intestinal submucosa (SIS) or human bladder acellular matrix (BAM), have gained more interest [9,10]. Both materials have been widely experimented in several animal models (rodents [11,12] dogs [13] and pigs [14]), showing the ability to act as biocompatible and biodegradable matrices, with good properties for tissuespecific morphological and functional regeneration [7,8]. SIS has been used in several indications in urology, without immunogenic reactions or side effects [11][12][13][14][15].…”

“…Both materials have been widely experimented in several animal models (rodents [11,12] dogs [13] and pigs [14]), showing the ability to act as biocompatible and biodegradable matrices, with good properties for tissuespecific morphological and functional regeneration [7,8]. SIS has been used in several indications in urology, without immunogenic reactions or side effects [11][12][13][14][15]. Promising results of tissue-engineered autologous bladders for patients needing cystoplasty have been recently presented [16].…”

Autologous urothelial cells transplantation onto a prefabricated capsular stent for tissue engineered ureteral reconstruction

“…However, using such naturally derived biomaterials leaves mach to be desired [32]. It is evident that replacement of a long segment of ureter using a cells-free ECM substitute ended in fibrosis unless healthy intact ureteral wall was left in anastomosis part [10,33]. On the other hand, collagenbased biodegradable materials have good regenerative capacity, but for some xenogeneic extracellular matrix, retention of cellular compounds within the matrix might cause chronic immunoreactions.…”