Kloskowski Tomasz, Pokrywczyńska Marta, Drewa Tomasz
Chair of Regenerative Medicine, Department of Tissue Engineering, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
Chair of Regenerative Medicine, Department of Tissue Engineering, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland ; Nicolaus Copernicus Hospital in Toruń, Department of General and Oncologic Urology, Toruń, Poland.
Cent European J Urol. 2015;68(1):109-14. doi: 10.5173/ceju.2015.01.448. Epub 2014 Dec 31.
Incontinent urinary diversion using an ileal conduit is the most popular method used by urologists after bladder cystectomy resulting from muscle invasive bladder cancer. The use of gastrointestinal tissue is related to a series of complications with the necessity of surgical procedure extension which increases the time of surgery. Regenerative medicine together with tissue engineering techniques gives hope for artificial urinary conduit construction de novo without affecting the ileum.
In this review we analyzed history of urinary diversion together with current attempts in urinary conduit construction using tissue engineering methods. Based on literature and our own experience we presented future perspectives related to the artificial urinary conduit construction.
A small number of papers in the field of tissue engineered urinary conduit construction indicates that this topic requires more attention. Three main factors can be distinguished to resolve this topic: proper scaffold construction along with proper regeneration of both the urothelium and smooth muscle layers.
Artificial urinary conduit has a great chance to become the first commercially available product in urology constructed by regenerative medicine methods.
对于因肌层浸润性膀胱癌行膀胱全切术后的患者,泌尿外科医生最常用的尿流改道术式是回肠膀胱术。使用胃肠道组织会引发一系列并发症,且手术范围必须扩大,这增加了手术时间。再生医学与组织工程技术为无需取用回肠即可全新构建人工尿道提供了希望。
在本综述中,我们分析了尿流改道的历史以及目前使用组织工程方法构建尿道的尝试。基于文献和我们自己的经验,我们阐述了与人工尿道构建相关的未来展望。
组织工程化尿道构建领域的文献数量较少,表明该主题需要更多关注。解决该主题可区分出三个主要因素:合适的支架构建以及尿路上皮和平滑肌层的适当再生。
人工尿道极有可能成为泌尿外科首个通过再生医学方法制造的上市产品。