Future perspectives in reconstructive surgery using tissue engineering.

Whenever there is a lack of native urologic tissue, reconstruction usually is performed with native nonurologic tissues, such as gastrointestinal segments, skin, or mucosa from multiple body sites. The use of native nonurologic tissues in the genitourinary tract is associated with adverse effects. Tissue engineering efforts currently are underway for almost every type of tissue and organ within the urinary system including bladder, ureter, urethra, and genitalia. Most of the efforts expended to engineer genitourinary tissues have occurred within the last decade. Tissue engineering techniques require a cell culture facility designed for human application. Personnel who have mastered the techniques of cell harvest, culture and expansion, and polymer design are essential for the successful application of this technology. The first human application of cell-based tissue engineering technology for urologic applications recently occurred with the injection of autologous cells for the correction of vesicoureteral reflux in children and urinary incontinence in adults. Trials involving bladder replacement using tissue engineering techniques currently are being arranged. Recent progress suggests that engineered urologic tissues may have clinical applicability.