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A stepwise treatment approach to neonatal genital prolapse

Pediatric Investigation 2018年第1期2卷 56-58页

作者： hatim thaker Isuru S. Jayaratna Zein K. Nakhoda Jenny Jaque Andy Y. Chang Institute of Urology University of Southern California Los Angeles CA USA Department of Urology Icahn School of Medicine at Mount Sinai New York NY USA Department of Obstetrics/Gynecology University of Southern California Los Angeles CA USA Division of Pediatric Urology Children's Hospital of Los Angeles Los Angeles CA USA

INTRODUCTIONNeonatal genital prolapse (NGP) is a rare phenomenon that is typically associated with spinal cord malformations. Several treatment methods have been described, on a case report basis, ranging from digital reduction, the intravaginal self-retaining device for pelvic support, to more invasive partial labial fusion. In this report, we describe a case of severe congenital neonatal genital prolapse and the management approach pursued.

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Regenerative medicine based applications to combat stress urinary incontinence

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World Journal of Stem Cells 2013年第4期5卷 112-123页

作者： hatim thaker Arun K Sharma Division of Pediatric Urology Ann & Robert H. Lurie Children's Hospital of Chicago Department of Urology Northwestern University Feinberg School of Medicine Institute for BioNanotechnology in Medicine(IBNAM) Northwestern University

Stress urinary incontinence(SUI), as an isolated symptom, is not a life threatening condition. However, the fear of unexpected urine leakage contributes to a significant decline in quality of life parameters for afflicted patients. Compared to other forms of incontinence, SUI cannot be easily treated with pharmacotherapy since it is inherently an anatomic problem. Treatment options include the use of bio-injectable materials to enhance closing pressures, and the placement of slings to bolster fascial support to the urethra. However, histologic findings of degeneration in the incontinent urethral sphincter invite the use of tissues engineering strategies to regenerate structures that aid in promoting continence. In this review, we will assess the role of stem cells in restoring multiple anatomic and physiological aspects of the sphincter. In particular, mesenchymal stem cells and CD34+cells have shown great promise to differentiate into muscular and vascular components,respectively. Evidence supporting the use of cytokines and growth factors such as hypoxia-inducible factor1-alpha, vascular endothelial growth factor, basic fi-broblast growth factor, hepatocyte growth factor and insulin-like growth factor further enhance the viability and direction of differentiation. Bridging the benefits of stem cells and growth factors involves the use of synthetic scaffolds like poly(1,8-octanediol-co-citrate)(POC) thin films. POC scaffolds are synthetic, elastomeric polymers that serve as substrates for cell growth,and upon degradation, release growth factors to the microenvironment in a controlled, predictable *** combination of cellular, cytokine and scaffold elements aims to address the pathologic deficits to urinary incontinence, with a goal to improve patient symptoms and overall quality of life.

关键词： Stress urinary incontinence Smooth muscle Tissue engineering Regeneration Stem cells Biomaterials Angiogenesis Sphincter

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