Constructing artificial urinary conduits: current capabilities and future potential

ABSTRACT Introduction: Intestinal segments are currently used in reconstructive urology to create urinary diversion after cystectomy. Ileal conduit (IC) is the dominant type of urinary diversion. Nevertheless, IC is not an ideal solution as the procedure still requires entero-enterostomy to restore the bowel continuity. This step is a source of relevant complications that might prolong recovery time. Fabrication of artificial urinary conduit is a tempting idea to introduce an alternative form of urinary diversion which might improve cystectomy outcomes. Area covered: The aim of this review is to discuss available research data about artificial urinary conduit and identify major challenges for future studies. Expert opinion: Fabrication of artificial urinary conduit is in range of current tissue engineering technology but there are still many challenges to overcome. There is an urgent need for studies to be conducted on large animal models with long follow up to expose the limitation of experimental strategies and to gather data for translational research.

[1]  J. Vacanti,et al.  Implantation in vivo and retrieval of artificial structures consisting of rabbit and human urothelium and human bladder muscle. , 1993, The Journal of urology.

[2]  J. Adolfsson,et al.  Risk of in-hospital complications after radical cystectomy for urinary bladder carcinoma: population-based follow-up study of 7608 patients , 2013, BJU international.

[3]  Y. Xiong,et al.  Tissue-engineered tubular substitutions for urinary diversion in a rabbit model , 2016, Experimental biology and medicine.

[4]  F. O'Brien,et al.  Effect of collagen-glycosaminoglycan scaffold pore size on matrix mineralization and cellular behavior in different cell types. , 2016, Journal of biomedical materials research. Part A.

[5]  John R. MacKay,et al.  Integrated modelling, design and analysis of submarine structures , 2015 .

[6]  E. Oosterwijk,et al.  Tubular Constructs as Artificial Urinary Conduits. , 2016, The Journal of urology.

[7]  T. Martini,et al.  Comparison of complications in three incontinent urinary diversions. , 2008, European urology.

[8]  James M. Anderson,et al.  Foreign body reaction to biomaterials. , 2008, Seminars in immunology.

[9]  R. Hautmann,et al.  A critical analysis of orthotopic bladder substitutes in adult patients with bladder cancer: is there a perfect solution? , 2010, European urology.

[10]  Anh-Vu Do,et al.  3D Printing of Scaffolds for Tissue Regeneration Applications , 2015, Advanced healthcare materials.

[11]  D. Neal Urodynamic investigation of the ileal conduit: upper tract dilatation and the effects of revision of the conduit. , 1989, The Journal of urology.

[12]  R. Wells Tissue mechanics and fibrosis. , 2013, Biochimica et biophysica acta.

[13]  Despina Bazou,et al.  Anastomosis of endothelial sprouts forms new vessels in a tissue analogue of angiogenesis. , 2012, Integrative biology : quantitative biosciences from nano to macro.

[14]  Xiao-ming Meng,et al.  TGF-β: the master regulator of fibrosis , 2016, Nature Reviews Nephrology.

[15]  Jinsung Park,et al.  Radical Cystectomy and Orthotopic Bladder Substitution Using Ileum , 2011, Korean journal of urology.

[16]  Jeffrey M Karp,et al.  Engineering Stem Cell Organoids. , 2016, Cell stem cell.

[17]  C. Ricordi,et al.  Does the Mesenchymal Stem Cell Source Influence Smooth Muscle Regeneration in Tissue-Engineered Urinary Bladders? , 2017, Cell transplantation.

[18]  Roger M. Ilagan,et al.  Regeneration of native-like neo-urinary tissue from nonbladder cell sources. , 2012, Tissue engineering. Part A.

[19]  A. Sarnowska,et al.  Phenotypic, Functional, and Safety Control at Preimplantation Phase of MSC-Based Therapy , 2016, Stem cells international.

[20]  R. Hautmann,et al.  Urinary diversion after radical cystectomy for bladder cancer: options, patient selection, and outcomes , 2014, BJU international.

[21]  L. Cui,et al.  Bladder reconstruction with adipose-derived stem cell-seeded bladder acellular matrix grafts improve morphology composition , 2010, World Journal of Urology.

[22]  Matthias W Laschke,et al.  Prevascularization in tissue engineering: Current concepts and future directions. , 2016, Biotechnology advances.

[23]  N. Khalil,et al.  Post translational activation of latent transforming growth factor beta (L-TGF-beta): clinical implications. , 2001, Histology and histopathology.

[24]  Jan Adamowicz,et al.  Human urinary bladder regeneration through tissue engineering – An analysis of 131 clinical cases , 2014, Experimental biology and medicine.

[25]  T. Drewa,et al.  The artificial conduit for urinary diversion in rats: a preliminary study. , 2007, Transplantation proceedings.

[26]  Y. Ceylan,et al.  Ureterocutaneostomy: for whom and when? , 2014, Turkish journal of urology.

[27]  Walter Lang,et al.  Investigations on the Impact of Material-Integrated Sensors with the Help of FEM-Based Modeling , 2015, Sensors.

[28]  E. Oosterwijk,et al.  Tissue engineered tubular construct for urinary diversion in a preclinical porcine model. , 2012, The Journal of urology.

[29]  R. Sinha,et al.  Prospective comparison of quality‐of‐life outcomes between ileal conduit urinary diversion and orthotopic neobladder reconstruction after radical cystectomy: a statistical model , 2014, BJU international.

[30]  J. Adamowicz,et al.  The relationship of cancer stem cells in urological cancers , 2013, Central European journal of urology.

[31]  E. Oosterwijk,et al.  Novel tubular constructs for urinary diversion: a biocompatibility study in pigs , 2017, Journal of tissue engineering and regenerative medicine.

[32]  M. Spielmann,et al.  Minced urothelium to create epithelialized subcutaneous conduits. , 2010, The Journal of urology.

[33]  A. Joyner,et al.  Roles for Hedgehog signaling in adult organ homeostasis and repair , 2014, Development.

[34]  M. Pokrywczyńska,et al.  Artificial urinary conduit construction using tissue engineering methods , 2014, Central European journal of urology.

[35]  M. Babjuk Bladder Cancer in the Elderly. , 2018, European urology.

[36]  Joseph P Vacanti,et al.  Principles of biomimetic vascular network design applied to a tissue-engineered liver scaffold. , 2010, Tissue engineering. Part A.

[37]  M. Cannas,et al.  Cardiovascular biomaterials: when the inflammatory response helps to efficiently restore tissue functionality? , 2014, Journal of tissue engineering and regenerative medicine.

[38]  J. Adamowicz,et al.  Urine is a highly cytotoxic agent: does it influence stem cell therapies in urology? , 2012, Transplantation proceedings.

[39]  Samir Mitragotri,et al.  Physical approaches to biomaterial design. , 2009, Nature materials.

[40]  M. Pokrywczyńska,et al.  Stem cells and differentiated cells differ in their sensitivity to urine in vitro , 2018, Journal of cellular biochemistry.

[41]  Esther Novosel,et al.  Vascularization is the key challenge in tissue engineering. , 2011, Advanced drug delivery reviews.

[42]  T. Kowalewski,et al.  New Amniotic Membrane Based Biocomposite for Future Application in Reconstructive Urology , 2016, PloS one.

[43]  A. Atala,et al.  Tissue-engineered conduit using urine-derived stem cells seeded bacterial cellulose polymer in urinary reconstruction and diversion. , 2010, Biomaterials.

[44]  Y. Lotan,et al.  Gender and Bladder Cancer: A Collaborative Review of Etiology, Biology, and Outcomes. , 2016, European urology.

[45]  Samo Hudoklin,et al.  Formation and maintenance of blood–urine barrier in urothelium , 2010, Protoplasma.

[46]  A. Basiri,et al.  The use of unaltered appendix transfer in ileal continent reservoir: 10 years experience, a novel technical modification. , 2009, Urology journal.

[47]  James J. Yoo,et al.  Tissue-engineered autologous bladders for patients needing cystoplasty , 2006, The Lancet.

[48]  Tomasz Kowalczyk,et al.  Tissue engineering of urinary bladder – current state of art and future perspectives , 2013, Central European journal of urology.

[49]  T. Ritter,et al.  Mesenchymal stem cell effects on T-cell effector pathways , 2011, Stem Cell Research & Therapy.

[50]  G. Hidas,et al.  Aerosol transfer of bladder urothelial and smooth muscle cells onto demucosalized colonic segments for bladder augmentation: in vivo, long term, and functional pilot study. , 2015, Journal of pediatric urology.

[51]  Arun K. Sharma,et al.  Tissue engineering for the oncologic urinary bladder , 2012, Nature Reviews Urology.

[52]  C. K. Chong,et al.  Fabrication of biodegradable synthetic perfusable vascular networks via a combination of electrospinning and robocasting. , 2015, Biomaterials science.

[53]  R. D. De Filippo,et al.  Autologous cell seeded biodegradable scaffold for augmentation cystoplasty: phase II study in children and adolescents with spina bifida. , 2014, The Journal of urology.

[54]  Y. Xiong,et al.  Tissue-engineered tubular graft for urinary diversion after radical cystectomy in rabbits. , 2013, The Journal of surgical research.

[55]  E. Zakhem,et al.  Tissue engineering and regenerative medicine as applied to the gastrointestinal tract. , 2013, Current opinion in biotechnology.

[56]  J. Witjes,et al.  MUSCLE-INVASIVE AND METASTATIC BLADDER CANCER , 2016 .

[57]  M. Pokrywczyńska,et al.  Urine--a waste or the future of regenerative medicine? , 2015, Medical hypotheses.

[58]  N. Smith,et al.  Tissue-Engineered Urinary Conduits , 2015, Current Urology Reports.

[59]  E. Bricker Bladder substitution after pelvic evisceration. , 1950, The Surgical clinics of North America.

[60]  E. Wallen,et al.  Analysis of intracorporeal compared with extracorporeal urinary diversion after robot-assisted radical cystectomy: results from the International Robotic Cystectomy Consortium. , 2014, European urology.

[61]  H. Dietz,et al.  Cajal-like cells in the upper urinary tract: comparative study in various species , 2005, Pediatric Surgery International.