This study investigates safety and efficacy of surgical treatment of patients with anterior urethral stricture using a tissue-engineered construct based on autologous buccal mucosa cells and matrix from reconstituted collagen and reinforcing polylactoglycolide fibers. This is a single arm study with no control. Success will be assessed via objective and subjective methods; complications will be tallied in a standardized fashion. Outcomes will be measured at five years.
Treatment of urethral strictures longer than 2 cm is an actual clinical challenge. In this case, the common method is replacement surgery using a buccal mucosa graft. However, the main disadvantage of this method is associated with limited donor resources and donor site morbidity. The aim of this study is to assess safety and efficacy of surgical treatment of patients with anterior urethral stricture using a tissue-engineered construct. The construct consists of autologous buccal mucosa cells and matrix from reconstituted collagen and reinforcing polylactoglycolide fibers. Patients will be followed up for 5 years within this study. The follow-up regimen includes retrograde and pericatheter urethrography, voiding cystourethrography, uroflowmetry, biopsy, and quality of life monitoring. Telephone follow-up will take place in between these assessments. The data obtained from this study will have practical implications for the urethral stricture treatment and will be based on the principles of evidence-based medicine.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
6
The investigators will perform urethroplasty with the tissue-engineered construct - epithelial cells isolated from patient's buccal mucosa and seeded on a collagen-polylactoglycolide matrix.
Sechenov University
Moscow, Russia
Serious adverse events
Frequency, type and severity of serious adverse events (SAE)
Time frame: 4 weeks after surgery
Serious adverse reactions
Frequency, type and severity of serious adverse reactions (SAR)
Time frame: 4 weeks after surgery
Retrograde urethrography
Influence of the surgery on the urethral lumen
Time frame: 5 years
Voiding cystourethrography
Full assessment of the urethral lumen after the surgery
Time frame: 5 years
Pericatheter urethrography
Assessment of absence or presence of contrast medium leakage outside the urethra
Time frame: 4 weeks after surgery
Biopsy
Control of anatomical urethral structure in the intervention place
Time frame: 4 months after surgery
Urodynamic changes via uroflowmetry - 1
Influence of the surgery on urinary flow rate: maximum flow rate
Time frame: 5 years
Urodynamic changes via uroflowmetry - 2
Influence of the surgery on urinary flow rate: average flow rate
Time frame: 5 years
Urodynamic changes via uroflowmetry - 3
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Influence of the surgery on urinary flow rate: total volume voided
Time frame: 5 years
Urodynamic changes via uroflowmetry - 4
Influence of the surgery on urinary flow rate: maximum flow time
Time frame: 5 years
Quality of life monitoring - 1
Quality of life estimated by validated questionnaires: Short Form (SF-36)
Time frame: 5 years
Quality of life monitoring - 2
Quality of life estimated by validated questionnaires: International Prostatic Symptom Score (IPSS)
Time frame: 5 years