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Autologous in vitro cultured urothelium in hypospadias repair{star, open}
Department of Woman and Child Health, Paediatric Surgery, Astrid Lindgren Children's Hospital, Stockholm, Sweden, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Department of Woman and Child Health, Paediatric Surgery, Astrid Lindgren Children's Hospital, Stockholm, Sweden.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Plastic Surgery, Hand Surgery and Burns . Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
Nordenskjöld, A., Department of Woman and Child Health, Paediatric Surgery, Astrid Lindgren Children's Hospital, Stockholm, Sweden, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
2007 (English)In: Journal of Pediatric Urology, ISSN 1477-5131, Vol. 3, no 1, 10-18 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To treat severe hypospadias with a transplant of autologous in vitro cultured urothelial cells on acellular dermis. Patients and methods: During 2000-2002 six patients aged 14-44 months with severe hypospadias were treated surgically with autologous urothelial cell transplants. All were born with scrotal or perineal hypospadias and pronounced chordee. All patients were subjected to a two-staged procedure starting with repair of the chordee. Urothelial cell harvesting via bladder lavage was performed during the first operation. The neourethra was constructed by using a transplant with cultured urothelium in an on-lay fashion. Patients have been followed 3-5.5 years. Results: All six boys are voiding through their neourethra without straining and have no residual urine after micturition. Five patients are using a standing voiding position and present bell shaped, urinary flow curves. One developed a stricture treated conservatively with persisting good effect (after more than 5 years). Two developed a fistula requiring surgical correction that was uneventful. The last patient developed an obstruction in the proximal anastomosis that was treated with an internal urethrotomy. Cosmetic appearance is good in all cases with good parental satisfaction. Urethroscopy in all patients show a wide penile neourethra. Biopsies indicate a mucosal lining consisting of urothelial cells in three cases. Conclusion: This technique is feasible for treatment of a selected group of hypospadias where pronounced chordee and shortage of preputial and penile skin complicates the creation of a neourethra. It may have other clinical implications including disorders such as bladder exstrophy and cloacal malformations, as well as mutilating traumatic injuries or cancer therapy. © 2006 Journal of Pediatric Urology Company.

Place, publisher, year, edition, pages
2007. Vol. 3, no 1, 10-18 p.
Keyword [en]
Autologous, Cell culture, Hypospadias, Tissue engineering, Transplantation, Urothelium
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-50007DOI: 10.1016/j.jpurol.2006.01.018OAI: oai:DiVA.org:liu-50007DiVA: diva2:270903
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2011-01-11

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