The promise of tissue engineering in urology

摘要

In this issue of The Journal 2 articles highlight how the field of tissue engineering, or what is now commonly referred to as regenerative medicine, is beginning to impact clinical urology. Zhang and Liao (page 544) demonstrated that 4-layer small intestinal submucosa (SIS) can be used in the unseeded technique to augment small neurogenic bladders.1 Six patients received SIS augmentation and all 6 had improvement in capacity and compliance. These results were somewhat different from those in a previous article on SIS augmentation.2 So what is the difference? How could one study with SIS show promising results and the other report negative outcomes? Zhang and Liao allude to several potential differences in their surgical techniques such as not using fibrin glue, which can inhibit regeneration, as well as the importance of bladder cycling in the postoperative period. These seemingly minor points could all have a large impact on the regenerative process.