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Tissue-engineered Construct Based on Buccal Mucosa Cells and Matrix From Collagen and Polylactoglycolide Fibers

Early Phase 1
Conditions
Urethral Stricture
Interventions
Procedure: Urethroplasty with a tissue-engineered construct
Registration Number
NCT03205670
Lead Sponsor
I.M. Sechenov First Moscow State Medical University
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.

Recruitment & Eligibility

Status
UNKNOWN
Sex
Male
Target Recruitment
6
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

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Urethroplasty with a tissue-engineered constructUrethroplasty with a tissue-engineered constructThe investigators will take a sample of the buccal mucosa to isolate epithelial cells. Autologous cells will be seeded on a hybrid matrix. Urethroplasty with this tissue-engineered construct will be performed. This is a single arm study with no control. All patients will undergo the surgical operation.
Primary Outcome Measures
NameTimeMethod
Serious adverse events4 weeks after surgery

Frequency, type and severity of serious adverse events (SAE)

Serious adverse reactions4 weeks after surgery

Frequency, type and severity of serious adverse reactions (SAR)

Secondary Outcome Measures
NameTimeMethod
Pericatheter urethrography4 weeks after surgery

Assessment of absence or presence of contrast medium leakage outside the urethra

Urodynamic changes via uroflowmetry - 45 years

Influence of the surgery on urinary flow rate: maximum flow time

Biopsy4 months after surgery

Control of anatomical urethral structure in the intervention place

Quality of life monitoring - 15 years

Quality of life estimated by validated questionnaires: Short Form (SF-36)

Voiding cystourethrography5 years

Full assessment of the urethral lumen after the surgery

Urodynamic changes via uroflowmetry - 25 years

Influence of the surgery on urinary flow rate: average flow rate

Urodynamic changes via uroflowmetry - 15 years

Influence of the surgery on urinary flow rate: maximum flow rate

Urodynamic changes via uroflowmetry - 35 years

Influence of the surgery on urinary flow rate: total volume voided

Quality of life monitoring - 25 years

Quality of life estimated by validated questionnaires: International Prostatic Symptom Score (IPSS)

Retrograde urethrography5 years

Influence of the surgery on the urethral lumen

Trial Locations

Locations (1)

Sechenov University

🇷🇺

Moscow, Russian Federation

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