Tissue engineering in urology for urethroplasty and hypospadias reconstructive management: a systematic review

Tissue engineering in urology for urethroplasty and hypospadias reconstructive management: a systematic review

Andrea P. Bolaños-Gómez 1 , Luz D. Gutiérrez-Castañeda 2 , Jhonatan S. Santafé-Galvis 1 , María A. Fajardo-Perdomo 2 , Rosangela Casanova-Libreros 3 , Jonathan Carvajal-Veloza 4

1 Servicio de Urología Pediátrica, Fundación Universitaria de Ciencias de la Salud, Hospital Infantil Universitario de San José, Bogotá, Colombia; 2 Departamento de Genética, Unidad de Bioingeniería y Nanotecnología, Fundación Universitaria de Ciencias de la Salud, Hospital Infantil Universitario de San José, Bogotá, Colombia; 3 Unidad de Vicerrectoría de Investigaciones, Servicio de Epidemiología e Investigación, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia; 4 Basic Science Group CBS-FUCS, Medicine Faculty, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia

*Correspondence: Jhonatan S. Santafé-Galvis. Email: john.santafe01@gmail.com

Abstract

Objective: To describe the applicability of tissue engineering in the surgical management of urethroplasty and complex hypospadias in pediatric urology. Method: A systematic review was conducted in databases PubMed, Cochrane, Ovid, Medline, Scopus, ClinicalTrials.gov, and LILACS, over the last three decades, on tissue engineering in the correction of hypospadias and urethroplasty. Results: A total of 33 studies were included, of which 9 were conducted in humans and 24 in animals. The overall assessment of the studies in humans was acceptable. A wide variety of scaffolds was identified, with acellular matrix being the main biological material used, yielding acceptable clinical functional results. Seeding with autologous cells demonstrated better performance and tissue regenerative capacity, the complication rate was variable, and aesthetic outcomes are rarely reported. Conclusions: The application of tissue engineering in hypospadias is increasing, although its efficacy cannot be determined with the current evidence, as adequate randomized clinical studies are lacking. It is a promising option in the management of hypospadias.

Keywords: Hypospadias. Tissue engineering. Urethra. Reconstructive surgery. Urologic surgical procedures. Pediatrics.

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