Abbas Tariq O, Mahdi Elsadig, Hasan Anwarul, AlAnsari Abdulla, Pennisi Cristian Pablo
Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
Department of Pediatric Surgery and Urology, Hamad General Hospital, Doha, Qatar.
Front Pediatr. 2018 Jan 22;5:283. doi: 10.3389/fped.2017.00283. eCollection 2017.
Hypospadias, characterized by misplacement of the urinary meatus in the lower side of the penis, is a frequent birth defect in male children. Because of the huge variation in the anatomic presentation of hypospadias, no single urethroplasty procedure is suitable for all situations. Hence, many surgical techniques have emerged to address the shortage of tissues required to bridge the gap in the urethra particularly in the severe forms of hypospadias. However, the rate of postoperative complications of currently available surgical procedures reaches up to one-fourth of the patients having severe hypospadias. Moreover, these urethroplasty techniques are technically demanding and require considerable surgical experience. These limitations have fueled the development of novel tissue engineering techniques that aim to simplify the surgical procedures and to reduce the rate of complications. Several types of biomaterials have been considered for urethral repair, including synthetic and natural polymers, which in some cases have been seeded with cells prior to implantation. These methods have been tested in preclinical and clinical studies, with variable degrees of success. This review describes the different urethral tissue engineering methodologies, with focus on the approaches used for the treatment of hypospadias. At present, despite many significant advances, the search for a suitable tissue engineering approach for use in routine clinical applications continues.
尿道下裂的特征是尿道口位于阴茎下方，是男性儿童常见的出生缺陷。由于尿道下裂的解剖表现差异巨大，没有一种单一的尿道成形术适用于所有情况。因此，出现了许多手术技术来解决修复尿道缺损所需组织短缺的问题，尤其是在严重的尿道下裂病例中。然而，目前可用手术方法的术后并发症发生率高达重度尿道下裂患者的四分之一。此外，这些尿道成形术技术对技术要求很高，需要相当丰富的手术经验。这些局限性推动了新型组织工程技术的发展，旨在简化手术过程并降低并发症发生率。几种生物材料已被考虑用于尿道修复，包括合成聚合物和天然聚合物，在某些情况下，这些材料在植入前已接种细胞。这些方法已在临床前和临床研究中进行了测试，取得了不同程度的成功。这篇综述描述了不同的尿道组织工程方法，重点是用于治疗尿道下裂的方法。目前，尽管取得了许多重大进展，但寻找适用于常规临床应用的合适组织工程方法的工作仍在继续。
