Urethral Stricture
Conditions
Keywords
Autologous Cells, Buccal Mucosa, Urethroplasty, Tissue-engineered Construct, Hybrid matrix, Collagen, Polylactoglycolide Fibers
Brief summary
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.
Detailed description
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.
Interventions
PROCEDUREUrethroplasty with a tissue-engineered construct
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.
Sponsors
I.M. Sechenov First Moscow State Medical University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
18 Years to 78 Years
Healthy volunteers
No
Inclusion criteria
* Patient signed informed consent form * Diagnosed anterior urethral stricture longer than 2.0 cm and shorter than 4.0 cm * At least one prior internal optical urethrotomy and/or urethral bougienage Non-inclusion Criteria: * Acute infectious diseases * Patient with decompensated heart and renal failure * Patient with non-compensated diabetes mellitus * Patient with malignant tumor * Patient with polyvalent allergy * Mental disorders * Post traumatic urethral strictures * Subtotal and total urethral strictures * Sexually transmitted infections * Hypersensitivity to any components of tissue-engineered constructs * Any clinical state which does not ensure the safe implementation of study procedure (investigator's view) * Other associated urethral strictures * Laboratory markers of active urethritis
Exclusion criteria
* Patient's refusal from the further participation in trial * Confirmed syphilis, HIV, hepatitis B or C infections * Patient who cannot be regularly examined due to any circumstances
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Serious adverse events | 4 weeks after surgery | Frequency, type and severity of serious adverse events (SAE) |
| Serious adverse reactions | 4 weeks after surgery | Frequency, type and severity of serious adverse reactions (SAR) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Urodynamic changes via uroflowmetry - 4 | 5 years | Influence of the surgery on urinary flow rate: maximum flow time |
| Quality of life monitoring - 1 | 5 years | Quality of life estimated by validated questionnaires: Short Form (SF-36) |
| Retrograde urethrography | 5 years | Influence of the surgery on the urethral lumen |
| Voiding cystourethrography | 5 years | Full assessment of the urethral lumen after the surgery |
| Urodynamic changes via uroflowmetry - 2 | 5 years | Influence of the surgery on urinary flow rate: average flow rate |
| Biopsy | 4 months after surgery | Control of anatomical urethral structure in the intervention place |
| Urodynamic changes via uroflowmetry - 1 | 5 years | Influence of the surgery on urinary flow rate: maximum flow rate |
| Quality of life monitoring - 2 | 5 years | Quality of life estimated by validated questionnaires: International Prostatic Symptom Score (IPSS) |
| Pericatheter urethrography | 4 weeks after surgery | Assessment of absence or presence of contrast medium leakage outside the urethra |
| Urodynamic changes via uroflowmetry - 3 | 5 years | Influence of the surgery on urinary flow rate: total volume voided |
Countries
Russia
Outcome results
None listed