Overcoming scarring in the urethra: Challenges for tissue engineering

Area of Science:

• Urology
• Regenerative Medicine
• Pathology

Background:

• Urethral stricture disease affects approximately 1% of males over 55.
• Stricture tissue is characterized by myofibroblasts, giant cells, and increased collagen, leading to vascular loss.
• Incidence varies globally based on population, geography, and income.

Purpose of the Study:

• To review the etiology of urethral strictures.
• To summarize current treatment strategies for urethral strictures.
• To discuss the challenges and potential of tissue-engineered buccal mucosa (TEBM) in urethral repair and learn from other fibrotic conditions.

Main Methods:

• Literature review of existing knowledge on urethral stricture etiology.
• Analysis of current treatment regimens for urethral strictures.
• Exploration of TEBM applications and challenges in urethral reconstruction.

Main Results:

• The etiology, location, length, patient age, and comorbidities influence treatment decisions.
• Recurrent fibrosis is a common issue in urethral strictures, necessitating innovative repair strategies.
• TEBM presents a promising but challenging avenue for urethral repair.

Conclusions:

• Understanding the multifactorial etiology of urethral strictures is crucial for effective management.
• Tissue-engineered buccal mucosa offers potential for recurrent urethral scarring but faces significant challenges.
• Cross-disciplinary learning from other fibrotic pathologies may inform future treatments for urethral strictures.