3D-bioprinted urethral grafts: Revolutionizing urethral stricture treatment

Urethral stricture disease remains a significant clinical challenge, often requiring complex surgical interventions with variable long-term success rates. Traditional approaches, including urethral dilation, endoscopic treatments, and urethroplasty using autologous grafts such as buccal mucosa, are limited by donor site morbidity, graft contraction, and suboptimal integration. Recent advancements in 3D-bioprinting have introduced a transformative alternative - bioengineered urethral grafts designed to replicate native tissue architecture and promote cellular integration. However, while these constructs aim to enhance long-term functionality, robust evidence confirming their dynamic and functional equivalence to native tissue remains limited. This review explores the latest developments in 3D-bioprinted urethral grafts, detailing bioink formulations, scaffold designs, and bioprinting techniques. Comparative analysis of conventional urethral reconstruction methods versus bioengineered grafts highlights the potential benefits of patient-specific, regenerative solutions. Additionally, we discuss preclinical and clinical progress, challenges in clinical translation, and future directions for optimizing bioprinted urethral constructs. By bridging regenerative medicine with urologic surgery, 3D-bioprinting holds the promise of revolutionizing urethral stricture treatment and improving patient outcomes.