Current status of tissue engineering in urology

Tissue engineering is a rapidly advancing technology that is shifting from the laboratory to urological practice. The review explores recent developments and considers the relationship to existing treatments.

Different strategies to generate transplantable tissue grafts in vitro and harness host regenerative processes for integration of grafts and biomaterials in vivo are common themes in the recent literature. Highlights include dynamic cell culture to precondition grafts and the use of omental wrapping to promote vascularization. Emphasis on specific cell culture conditions is set to shift towards the monitoring of differentiation and functional outcome. The future might encompass the use of stem cells to overcome the issues of harvesting cells from diseased tissues. Improved understandings of scaffold and cell interactions are particularly important to advance graft development and outcome. Recent trials give some indication of clinical outcome for tissue-engineered treatments, but patient benefit could be difficult to interpret in salvage cases.

Tissue engineering applications can be broken down into tissue- or organ-based approaches, only through examining these in clinical settings can potential success can be judged. Treatments must be appropriately evaluated for risk/benefit in comparison to existing treatments. This approach requires open and robust debate amongst clinicians and scientists.