Wilczek P, Bociaga D, Krakos M, Wierzbicka A
Faculty of Health Sciences, Calisia University, Kalisz, Poland.
Heart Prostheses Institute, Prof. Z. Religa Foundation of Cardiac Surgery Development, Zabrze, Poland.
Front Bioeng Biotechnol. 2025 Jul 2;13:1611508. doi: 10.3389/fbioe.2025.1611508. eCollection 2025.
Reconstructing the urinary tract in patients with hypospadias poses a significant clinical challenge. Despite numerous surgical approaches available, outcomes remain unsatisfactory due to the complexity of the condition and the lack of standardized conventional methods. Material requirements for reconstruction are stringent, necessitating resistance to fluids, adherence, and prevention of hair growth and strictures. Materials should also be biocompatible with the ability to control their biodegradation rate.
A systemic search of PubMed database for studies between 2021 and 2024 was performed. The search terms included surgical methods hypospodia, stem cells in urethra reconstruction, polymer materials used in hypospodia, preclinical and clinical study in reconstruction of urinary system, tissue engineered methods used in urinary reconstruction.
Treatment options are notably limited for patients requiring lengthy urethral fragments, primarily due to the scarcity of autologous tissue, particularly penile skin. There is still debate whether using a one- or two-stage surgical procedure is more appropriate. Regardless of the surgical technique used, the number of complications increases over time. It's justify the search for new methods of urethral reconstruction Consequently, tissue engineering techniques, cell therapies, and advancements in biomaterials offer promising alternatives to traditional urinary tract reconstruction methods. However, it should be noted that at present, despite the promising results of studies, the translation of these studies into clinical practice is still unsatisfactory.
While notable advancements have occurred in tissue engineering methods, cell therapies, and modern biomaterials in recent years, the translation of laboratory findings to preclinical and clinical applications remains inadequate. This deficiency primarily stems from the absence of standardization and the relatively short duration of clinical trial follow-ups.
尿道下裂患者的尿路重建是一项重大的临床挑战。尽管有多种手术方法可用，但由于病情复杂且缺乏标准化的传统方法，治疗效果仍不尽人意。重建所需的材料要求严格，需要具备抗流体性、粘附性，并能防止毛发增生和狭窄。材料还应具有生物相容性，并能够控制其生物降解速率。
对PubMed数据库进行系统检索，以查找2021年至2024年期间的研究。检索词包括尿道下裂的手术方法、尿道重建中的干细胞、尿道下裂中使用的聚合物材料、泌尿系统重建的临床前和临床研究、尿路重建中使用的组织工程方法。
对于需要长段尿道重建的患者，治疗选择明显有限，主要原因是自体组织稀缺，尤其是阴茎皮肤。对于采用一期还是二期手术更为合适仍存在争议。无论采用何种手术技术，并发症的数量都会随着时间的推移而增加。因此，寻找新的尿道重建方法是合理的。组织工程技术、细胞疗法和生物材料的进步为传统尿路重建方法提供了有前景的替代方案。然而，应该注意的是，目前尽管研究结果很有前景，但这些研究转化为临床实践仍不尽人意。
近年来，组织工程方法、细胞疗法和现代生物材料取得了显著进展，但实验室研究结果转化为临床前和临床应用仍不充分。这一不足主要源于缺乏标准化以及临床试验随访时间相对较短。
