Tissue Engineering for Gastrointestinal and Genitourinary Tracts

The gastrointestinal and genitourinary tracts share several similarities. Primarily, these tissues are composed of hollow structures lined by an epithelium through which materials need to flow with the help of peristalsis brought by muscle contraction. In the case of the gastrointestinal tract, solid or liquid food must circulate to be digested and absorbed and the waste products eliminated. In the case of the urinary tract, the urine produced by the kidneys must flow to the bladder, where it is stored until its elimination from the body. Finally, in the case of the vagina, it must allow the evacuation of blood during menstruation, accommodate the male sexual organ during coitus, and is the natural way to birth a child. The present review describes the anatomy, pathologies, and treatments of such organs, emphasizing tissue engineering strategies.

Newer developments of extra-anatomic bypass

We have analyzed our eight year experience with more than 200 instances of extra-anatomic bypass and have made certain observations. Extra-anatomic bypass provides an acceptable alternative to extensive direct intra-abdominal and intrathoracic vascular reconstructive procedures. This is particularly true in high risk patients and in the presence of infection. While axillobifemoral bypass is widely known and used, other types of extra-anatomic bypass are emphasized. These are axillary-axillary, axillopopliteal, axillotibial and axillofemoral bypass under local anesthesia. Technical factors, such as the type of graft, the course of the bypass and ancillary techniques to improve the long term patency, are also discussed herein.

Tissue Engineering in Gynecology

Female gynecological organ dysfunction can cause infertility and psychological distress, decreasing the quality of life of affected women. Incidence is constantly increasing due to growing rates of cancer and increase of childbearing age in the developed world. Current treatments are often unable to restore organ function, and occasionally are the cause of female infertility. Alternative treatment options are currently being developed in order to face the inadequacy of current practices. In this review, pathologies and current treatments of gynecological organs (ovaries, uterus, and vagina) are described. State-of-the-art of tissue engineering alternatives to common practices are evaluated with a focus on in vivo models. Tissue engineering is an ever-expanding field, integrating various domains of modern science to create sophisticated tissue substitutes in the hope of repairing or replacing dysfunctional organs using autologous cells. Its application to gynecology has the potential of restoring female fertility and sexual wellbeing.