Abstract
Urinary tract is subjected to many varieties of pathologies since birth including congenital anomalies, trauma, inflammatory lesions, and malignancy. These diseases necessitate the replacement of involved organs and tissues. Shortage of organ donation, problems of immunosuppression, and complications associated with the use of nonnative tissues have urged clinicians and scientists to investigate new therapies, namely, tissue engineering. Tissue engineering follows principles of cell transplantation, materials science, and engineering. Epithelial and muscle cells can be harvested and used for reconstruction of the engineered grafts. These cells must be delivered in a well-organized and differentiated condition because water-seal epithelium and well-oriented muscle layer are needed for proper function of the substitute tissues. Synthetic or natural scaffolds have been used for engineering lower urinary tract. Harnessing autologous cells to produce their own matrix and form scaffolds is a new strategy for engineering bladder and urethra. This self-assembly technique avoids the biosafety and immunological reactions related to the use of biodegradable scaffolds. Autologous equivalents have already been produced for pigs (bladder) and human (urethra and bladder). The purpose of this paper is to present a review for the existing methods of engineering bladder and urethra and to point toward perspectives for their replacement.
Highlights
Lower urinary tract is composed of urinary bladder (UB), urethra, and urinary sphincters
Since the intestine is structurally and functionally different from urinary bladder, many complications exist [3, 4] such as hypocontractility, hematuria, dysuria, urolithiasis, neoplasia, ectopic mucus production, and metabolic imbalances due to urine absorption by the intestinal mucosa
Urinary bladder and urethra are consisting of epithelium on the lumen surrounded by a collagen rich connective tissue and muscle layer
Summary
Lower urinary tract is composed of urinary bladder (UB), urethra, and urinary sphincters. Many pathologies affect the urinary bladder and urethra and health and quality of life of the patients at different ages and sexes and demand their replacement These diseases have high incidence and long-term impact, which increase the burden of health systems all over the world. Since the intestine is structurally and functionally different from urinary bladder, many complications exist [3, 4] such as hypocontractility, hematuria, dysuria, urolithiasis, neoplasia, ectopic mucus production, and metabolic imbalances due to urine absorption by the intestinal mucosa The latter can induce delay of growth and reduction of bone density in pediatric patients [5,6,7,8]. That is why the field of tissue engineering and regenerative medicine has evolved to compensate for the replacement of these organs to prevent complications and improve the quality of life for patients suffering from major diseases necessitating bladder and urethral substitution
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