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Asian Journal of Urology, 2018, 5(2): 69-77    doi: 10.1016/j.ajur.2018.02.002
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Overcoming scarring in the urethra: Challenges for tissue engineering
Simsek Abdulmuttalipab,Aldamanhori Reema,R.Chapple Christophera,MacNeil Sheilab()
a Department of Urology, Royal Hallamshire Hospital, Sheffield, UK
b Department of Materials Science & Engineering, Kroto Research Institute, University of Sheffield,Sheffield, UK
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Abstract: 

Urethral stricture disease is increasingly common occurring in about 1% of males over the age of 55. The stricture tissue is rich in myofibroblasts and multi-nucleated giant cells which are thought to be related to stricture formation and collagen synthesis. An increase in collagen is associated with the loss of the normal vasculature of the normal urethra. The actual incidence differs based on worldwide populations, geography, and income. The stricture aetiology, location, length and patient's age and comorbidity are important in deciding the course of treatment. In this review we aim to summarise the existing knowledge of the aetiology of urethral strictures, review current treatment regimens, and present the challenges of using tissue-engineered buccal mucosa (TEBM) to repair scarring of the urethra. In asking this question we are also mindful that recurrent fibrosis occurs in other tissues—how can we learn from these other pathologies?

Key words:  Urethral strictures    Fibrosis    Tissue-engineered buccal mucosa    Augmentation urethroplasty
收稿日期:  2016-11-09      修回日期:  2017-04-21      接受日期:  2017-10-30      出版日期:  2018-04-10      发布日期:  2018-06-09      整期出版日期:  2018-04-10
引用本文:    
. [J]. Asian Journal of Urology, 2018, 5(2): 69-77.
Simsek Abdulmuttalip,Aldamanhori Reem,R.Chapple Christopher,MacNeil Sheila. Overcoming scarring in the urethra: Challenges for tissue engineering. Asian Journal of Urology, 2018, 5(2): 69-77.
链接本文:  
http://www.ajurology.com/CN/10.1016/j.ajur.2018.02.002  或          http://www.ajurology.com/CN/Y2018/V5/I2/69
Penile, % Bulbar, %
Iatrogenic 40 35
Idiopathic 15 40
Inflammatory 40 10
Traumatic 5 15
Table 1  Stricture aetiology by location [12].
  
  
Factors Risk ratio (range)
Diseases
Smoking 1.8 (1.0-3.1)
Diabetes mellitus 2.0 (0.8-4.9)
Chronic obstructive pulmonary disease 1.3 (0.4-4.4)
Connective tissue disease 1.3 (0.3-4.7)
Coronary artery disease 1.0 (0.4-2.5)
Stricture aetiology
Trauma 2.6 (0.98-6.9)
Iatrogenic 3.4 (1.2-10)
Infectious 7.3 (2.3-23.7)
Lichen sclerosus 5.9 (2.1-16.5)
Radiation 3.3 (0.8-14)
Location
Anterior 0.49 (0.2-1.2)
Posterior 0.67 (0.3-1.7)
Panurethral 1.4 (0.38-5)
Prior treatment
Urethroplast 6.9 (2.1-22.6)
Urethrotomy 0.8 (0.2-2.8)
Dilation 0.7 (0.3-1.4)
Hypospadias 1.6 (0.7-3.9)
Stricture length >5 cm 2.3 (1.2-4.5)
Age 0.99 (0.98-1.01)
Table 2  Risk factors for stricture recurrence [80-83].
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