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Resorbable extracellular matrix grafts in urologic reconstruction
Richard A Santucci1, Theodore D Barber
1Wayne State University School of Medicine, Detroit, Michigan, USA. rsantucc@med.wayne.edu
Summary
Resorbable acellular extracellular matrices (ECMs) are promising for urologic reconstruction, particularly as slings or bolstering layers. Further research is needed to address inflammation and improve outcomes for conditions like Peyronie's disease before widespread adoption.
Area of Science:
- Urology
- Tissue Engineering
- Biomaterials
Background:
- A growing body of literature exists on tissue-engineering products for urologic applications.
- Simple, resorbable acellular extracellular matrices (ECMs) derived from animals represent a successful approach.
- ECMs have been utilized in various challenging urologic reconstruction scenarios.
Purpose of the Study:
- To summarize the complex literature on ECMs for practicing urologists.
- To review the clinical applications of resorbable acellular xenograft matrices in urologic reconstruction.
Main Methods:
- A Medline search was conducted using terms such as "SIS, small intestinal submucosa, ECM, extracellular matrix, acellular matrix, and urologic reconstruction."
- Relevant manuscripts were also identified from the bibliographies of primary references.
Main Results:
- Resorbable acellular xenograft matrices are the current state-of-the-art in tissue engineering for urologic reconstruction.
- Potential applications include pubovaginal slings and bolstering layers for ureteral or urethral repairs.
- Preliminary data on urethral patch grafts is mixed, requiring more investigation.
Conclusions:
- ECMs show promise but require further research due to issues like inflammation and repair failures.
- Extended uses like bladder augmentation and ureteral replacement need more supporting data.
- The future may involve cell-seeded grafts for off-the-shelf solutions, but current ECMs partially meet reconstructive needs.