- Hypospadias is a congenital defect where the
urethral opening is on the underside of the penis, instead of being at the tip.
- It causes abnormal curvature of the
penis (chordee) and spraying of urine while passing
- Presently, treatment involves
surgical repair with an autograft
employing tissue from the inner aspect of the cheek
- Research shows that graft made from
the patient's bone marrow stem cells are effective in urethral repair, with
Graft made from patient's own bone marrow stem cells
proven to be effective in repair of hypospadias, with better healing and
minimal scarring, says a recent study.
of the Study
Scientists have shown in the study using an animal
model, that it is possible and effective to employ a graft made from the
patient's own bone marrow stem cells, for repair of urethra in hypospadias
‘Novel urethral repair for treatment of hypospadias, using bone marrow stem cells appears promising with lesser complications.’
The stem cells were then seeded on a new synthetic
scaffold which is non-toxic, biodegradable and can expand and contract. The
graft thus obtained, promoted regeneration of the damaged tissue at many
"Using two unique populations of stem cells derived
from the bone marrow, we were able to temper
the inflammatory response and avoid scar tissue
," said Dr. Arun Sharma,
PhD, senior author and Director of Pediatric Urological Regenerative
Medicine/Surgical Research, Stanley Manne Children's Research Institute at Ann
& Robert H. Lurie Children's Hospital of Chicago. "We also saw that new
blood vessels were sprouting after the graft, which is important for tissue
healing and growth."
The novel use of stem cells and synthetic scaffolding
material in this study follows Dr Sharma's earlier work in bladder tissue
repair and regeneration.
"With this approach, a child would no longer need to suffer from complications of the
current treatment for hypospadias
," said Sharma, a sentiment echoed by
Joceline Liu, MD, first author and Urology Resident, Northwestern Memorial
Hypospadias is a
occurring in boys with the urethral opening on the underside of the
penis, instead of being at the tip. It happens in 1 out of every 200 births.
- Downward curvature of the penis (chordee)
- Abnormal spraying while passing urine
- Inability to urinate while standing
untreated, it can cause complications during adult life, with difficulty in
sustaining an erection and difficulties during intercourse.
is usually diagnosed at birth, and surgical correction is performed between 3
to 18 months of age. Reconstruction is undertaken using graft tissue taken from the inner aspect of the
child's cheek. This method may be associated with various complications,
occasionally necessitating multiple operations.
Recent Advances in Urethral Repair Surgery -
disorders such as hypospadias, malignancy, and trauma, of the genitourinary
tract may cause considerable structural damage to the organ or functional loss,
that needs correction by reconstruction or replacement of the damaged tissue. Tissue engineering involves the generation of
that have the potential to restore normal structure and
function. Most of the tissue regeneration research has taken place in the past
decade, and has found application in the field of urologic reconstruction
Urethral repair typically involves the use of a
scaffolding on which cells are seeded
. The current study used a synthetic scaffolding
material that satisfied the criteria of an ideal scaffold such as being
bioresorbable and biodegradable, and having favorable physical and mechanical properties.
In addition, it should aid the proliferation of seeded stem cells and also
ingrowth of native cells following implantation.
Stem cells are capable of self-renewal and
differentiation into a variety of cellular types
. Due to the ethical
issues involving the use of embryos to obtain stem cells, stem cells are being
harvested from adult organs such as the bone marrow.
Future Research Plans
studies on animal models have yielded favorable results. The authors plan enlarge upon their initial
research, and conduct animal testing followed by clinical trials before it can
be tried on children.
"Before we can use it in children, however, we will
need to conduct more studies in animal models, followed by future clinical
trials. The findings of this study lay a promising foundation for continued
- Facts About Hypospadias - (http://www.cdc.gov/ncbddd/birthdefects/hypospadias.html)
- Hypospadias - (http://www.mayoclinic.org/diseases-conditions/hypospadias/basics/symptoms/con-20031354)
- Tissue Engineering of the Penis -