The treatment options for patients requiring repair of a long segment of the urethra are limited by the availability of autologous tissues. We previously reported that acellular collagen-based tubularized constructs seeded with cells are able to repair small urethral defects in a rabbit model.
We explored the feasibility of engineering clinically relevant long urethras for surgical reconstruction in a canine preclinical model.
Design, setting, and participants
Autologous bladder epithelial and smooth muscle cells from 15 male dogs were grown and seeded onto preconfigured collagen-based tubular matrices (6
Outcome measurements and statistical analysis
Statistical analysis of CT imaging and histology was not needed.
Results and limitations
CT urethrograms showed wide-caliber urethras without strictures in animals implanted with cell-seeded matrices. The urethral segments replaced with acellular scaffolds collapsed. Gross examination of the urethral implants seeded with cells showed normal-appearing tissue without evidence of fibrosis. Histologically, an epithelial cell layer surrounded by muscle fiber bundles was observed on the cell-seeded constructs, and cellular organization increased over time. The epithelial and smooth muscle phenotypes were confirmed using antibodies to pancytokeratins AE1/AE3 and smooth muscle–specific desmin. Formation of an epithelial cell layer occurred in the unseeded constructs, but few muscle fibers formed.
Cell-seeded tubularized collagen scaffolds can be used to repair long urethral defects, whereas scaffolds without cells lead to poor tissue development and strictures. This study demonstrates that long tissue-engineered tubularized urethral segments may be used for urethroplasty in patients.
Keywords: Urethra, Stricture repair, Cell-seeded tubularized urethra reconstruction, Tissue-engineered urethra.
a Department of Urology and Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA
b Urology Department, Assiut University, Egypt 71516
Corresponding author. Wake Forest Institute for Regenerative Medicine, Wake Forest University Health Sciences, Medical Center Blvd., Winston Salem, NC 27157, USA. Tel. +1 336 716 5701; Fax: +1 336 716 0656.
© 2012 European Association of Urology, Published by Elsevier B.V.