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Tissue engineered buccal mucosa for urethroplasty: progress and future directions
N I Osman1, C Hillary1, A J Bullock2
1Kroto Research Institute, University of Sheffield, Sheffield, UK; Department of Urology, Royal Hallamshire Hospital, Sheffield, UK.
Advanced Drug Delivery Reviews
|December 3, 2014
Summary
Tissue engineered buccal mucosa offers a promising alternative for urethral stricture repair, potentially reducing donor site morbidity. However, long-term success is limited by fibrosis and stricture recurrence in some patients.
Area of Science:
- Regenerative Medicine
- Urology
- Biomaterials Science
Background:
- Autologous buccal mucosa is a common graft for urethral strictures.
- Extensive strictures necessitate large grafts, increasing donor site morbidity.
- Tissue engineering offers a potential alternative to autologous tissue grafts.
Purpose of the Study:
- To review advancements in tissue-engineered buccal mucosa for urethral reconstruction.
- To assess the potential of engineered tissues as an alternative graft material.
- To evaluate progress in addressing donor site morbidity associated with traditional grafts.
Main Methods:
- Review of clinical studies on tissue-engineered buccal mucosa implantation.
- Assessment of cell-seeded scaffolds (biological and synthetic) in patient studies.
- Evaluation of outcomes including tissue integration, long-term success, and adverse events like fibrosis.
Main Results:
- Early clinical studies show good acute tissue integration with buccal mucosa cells on scaffolds (dermis, collagen, synthetic).
- Urothelial cells on synthetic substrates also demonstrate promising initial integration.
- Long-term outcomes vary, with some patients experiencing recurrence and others doing well.
- Animal studies indicate that acellular biomaterials can lead to fibrosis in long urethral defects.
Conclusions:
- Tissue-engineered buccal mucosa demonstrates potential as a substitute for native tissue in urethral repair.
- Observed fibrosis months post-implantation may indicate recurrence of the underlying disease process.
- Further research is needed to improve long-term graft durability and prevent stricture recurrence.
