Bioengineering solutions for ureteric disorders: clinical need, challenges and opportunities

Area of Science:

• Regenerative Medicine
• Urology
• Biomaterials Science

Background:

• Ureteric damage, often caused by iatrogenic injury or trauma, necessitates effective treatments.
• Current therapeutic options, including stent placement and surgical reconstruction, have limitations such as scarring, strictures, and infections.

Purpose of the Study:

• To review the causes of ureteric damage and current treatments.
• To explore the potential of ureteric bioengineering as a future solution.
• To define the ideal characteristics of a bioengineered ureteric graft.

Main Methods:

• A literature search was conducted in February 2021 across Google Scholar, Medline, and Web of Science.
• Searches focused on ureteric pathology epidemiology, current care standards, and advancements in ureteric bioengineering.

Main Results:

• Iatrogenic injury and external trauma are primary causes of ureteric damage.
• Bioengineered ureteric alternatives in animal studies show potential, with natural grafts and hybrid materials yielding better outcomes.
• Cell-seeded scaffolds, particularly with stem cells or urothelial cells, demonstrate improved function over acellular options.

Conclusions:

• There is a significant unmet need for improved treatments for ureteric injuries.
• Urological bioengineering presents a promising avenue, demonstrated in preclinical research.
• Overcoming scientific, logistical, and economic hurdles is crucial to realize the clinical potential of ureteric bioengineering.