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Advances in tissue engineering hold great promise for pediatric urology

Howard M. Snyder, III, MD
Minimally invasive surgical approaches and stone disease have been important topics in pediatric urology in recent years, and urologists can expect to hear more about these areas at the 2011 AUA annual meeting and beyond.

However, without a doubt, continuing progress in the area of tissue engineering holds the greatest potential impact, not just in pediatric urology or even the entire specialty, but for medicine and society as a whole, according to Howard M. Snyder, III, MD, professor of surgery in urology, University of Pennsylvania School of Medicine, Philadelphia.

Speaking to Urology Times, Dr. Snyder referred to research being presented by Anthony Atala, MD, PhD, and colleagues from the Wake Forest University Institute for Regenerative Medicine, Winston-Salem, NC, as the most important AUA paper in pediatric urology and perhaps overall. Their report demonstrates success with in vitro reconstitution of human kidney structures from single cultured human renal cells.

"Considering the number of people receiving dialysis for end-stage renal failure and the mismatch between kidney transplant donors and demand, the possibility of correcting renal failure through cell-based therapy has enormous implications," Dr. Snyder said. "It would result in tremendous savings in health care costs and bring a huge improvement in quality of life for affected patients.

"Looking ahead, we can expect to hear more about tissue-engineering approaches for replacing multiple tissue and organs. Dr. Atala and his team have already engineered bladders and tubularized urethra from autologous cells that have been successfully transplanted in patients, and there is no theoretical reason preventing this technology from being developed for replacing the liver in hepatic failure or the pancreas in diabetes."

The synergy between two large NIDDK-sponsored studies and pharmaceutical research will soon bring new treatments and etiologic insight to interstitial cystitis/bladder pain syndrome.

In the area of urologic infections and inflammation, research to be presented at this year's AUA annual meeting in Washington will highlight an ongoing trend toward understanding and attempting to modify the human microbiologic environment for patients' benefit.

Results from a retrospective exploratory study of patients with urge incontinence and detrusor overactivity suggest that leakage and the pressure at which it occurs have potential predictive and therapeutic value.

Advancing technology is pushing clinicians and patients into making ever more nuanced decisions between the costs of a procedure and its value.

The newest urology products and services from IPC Medical Corp., Mission Pharmacal, Microline Surgical, Inc., the American Medical Group Association, Uramix, Inc., WellComm, and Graceway Pharmaceuticals, Inc.