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Tissue Engineering Opportunities for Vaginal Replacement in a Pediatric Population
Christopher Foster1, Ryan Daigle1, Courtney K Rowe2
1Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
Insights
Tissue engineering shows promise for creating vaginal replacements in children with vaginal agenesis. This review highlights current progress and potential for future clinical applications to improve patient quality of life.
Area of Science:
- Regenerative Medicine
- Biomedical Engineering
- Gynecologic Surgery
Background:
- Congenital vaginal agenesis presents significant challenges in pediatric treatment.
- Current treatment options lack a definitive gold standard for tissue replacement.
- Autologous tissue-engineered vaginal reconstruction offers potential for improved quality of life.
Purpose of the Study:
- To critically review the literature on tissue engineering for vaginal reconstruction in pediatric patients.
- To assess the current state of research and identify progress in the field.
- To provide a basis for future preclinical and clinical studies.
Main Methods:
- Systematic literature search of PubMed (January 2003 - December 2020).
- Inclusion of nine studies focusing on pediatric vaginal tissue engineering.
- Comparative analysis of study models, methods, cell types, scaffolds, and evaluation timelines.
Main Results:
- Three studies utilized in vitro models, while six employed in vivo designs.
- One in vivo study successfully investigated autologous vaginal epithelial cells in human trials.
- The review synthesizes current knowledge on engineered vaginal replacements.
Conclusions:
- Tissue engineering advancements offer a promising avenue for treating congenital vaginal anomalies.
- Further research is needed to optimize engineered vaginal replacements for pediatric use.
- This field holds potential to enhance surgical interventions and improve patient outcomes.
Abstract:
Treatment for children born with vaginal agenesis remains difficult, without a clear gold standard for tissue replacement. An autologous-engineered vaginal replacement would significantly improve quality of life for people born with this condition. The aim of this study was to critically review literature on the current state of tissue engineering for vaginal reconstruction in a pediatric population. An electronic literature search was conducted using PubMed for articles describing pediatric vaginal tissue engineering from January 2003 to December 2020. Nine studies met inclusion criteria and were reviewed. The model, methods, cell type and source, scaffold type, and time of analysis and evaluation were compared. Three studies used in vitro and six used an in vivo design. Of the six in vivo studies, one was able to investigate autologous vaginal epithelial cells in human clinical trials. This review discusses the current knowledge and progress of vaginal tissue engineered replacements that can potentially be used as a basis for both future preclinical animal and clinical human studies. Impact statement The current methods of treatment for congenital vaginal anomalies leave room for improvement. The state of tissue engineering may provide a method to improve the surgical interventions provided for these patients, in hopes of providing increased vaginal functionally and quality of life.
