Buccal epithelium Expanded and Encapsulated in Scaffold-Hybrid Approach to Urethral Stricture (BEES-HAUS) procedure: A novel cell therapy-based pilot study

Int J Urol. 2019 Feb;26(2):253-257. doi: 10.1111/iju.13852. Epub 2018 Nov 22.

Abstract

Objectives: To describe the feasibility of a novel cell-based endoscopic technique using buccal epithelium, expanded and encapsulated in a thermoreversible gelation polymer scaffold for the treatment of urethral stricture.

Methods: Six male patients with bulbar urethral stricture ranging from 2.0 to 3.5 cm in length were included in this pilot study. Autologous buccal epithelial cells from a small buccal mucosal biopsy were isolated, cultured and encapsulated in thermoreversible gelation polymer scaffold, and were implanted at the stricture site after a wide endoscopic urethrotomy.

Results: All the patients voided well, with a mean peak flow rate of 24 mL/s. Urethroscopy carried out at 6 months showed healthy mucosa at the urethrotomy site. However, two of the six patients had recurrence at 18 and 24 months, respectively.

Conclusions: This endoscopic-based Buccal epithelium Expanded and Encapsulated in Scaffold-Hybrid Approach to Urethral Stricture (BEES-HAUS) technique is a promising alternative for the open substitution buccal graft urethroplasty. It is possible to achieve the benefits of open substitution buccal urethroplasty with this endoscopic technique.

Keywords: buccal mucosa; cell therapy; scaffold; urethral stenosis; urethral stricture.

MeSH terms

  • Adult
  • Aged
  • Cell- and Tissue-Based Therapy / methods*
  • Endoscopy / methods*
  • Humans
  • Male
  • Middle Aged
  • Mouth Mucosa / transplantation
  • Pilot Projects
  • Plastic Surgery Procedures / methods*
  • Recurrence
  • Tissue Scaffolds
  • Treatment Outcome
  • Urethra / diagnostic imaging
  • Urethra / pathology
  • Urethra / surgery
  • Urethral Stricture / diagnostic imaging
  • Urethral Stricture / pathology
  • Urethral Stricture / surgery*
  • Urologic Surgical Procedures, Male / methods*