В Индии внедрена новая методика лечения сужения мочеиспускательного канала с использованием собственных клеток пациента

For nearly 2 years, Mr Chanakya [name changed], a 34-year-old from Dharwad, lived with the wrong diagnosis. His symptoms indicated a diagnosis of neurogenic bladder, a nerve-related disorder causing difficulty in urination, for which he received treatment with no relief. It was only when he travelled to Bangalore and had his condition re-examined that the real underlying issue was detected. Although routine radiological scans were inconclusive, a diagnostic cystoscopy finally confirmed his diagnosis – a bulbar urethral stricture, a short, tight narrowing in his urethra. Urethral strictures, scar tissue that narrows the urethra and obstructs the flow of urine, are more common than widely recognised. The standard treatment, Visual Internal Urethrotomy (VIU), uses a small blade passed through a cystoscope to cut open the narrowed segment. It is minimally invasive, but it carries a serious shortcoming: the scar tissue grows back in 60 to 70 % of patients within a few years, forcing repeated procedures. The more durable option is a urethroplasty, an open surgery where a deep cut is required into the perineum and a graft of tissue, harvested from the inner lining of the cheek, to reconstruct the urethra. Results are durable, but the procedure is invasive, requiring hospitalisation and a longer recovery. Mr Chanakya's treatment needed a third alternative, avoiding the shortcomings of both procedures. After giving deep thought, Dr Ravi Shankar J C, Consultant - Urology (Advanced Endourology, Andrology, Renal Transplant, Robotic Urology), Manipal Hospital Kanakapura Road, offered him something that had not existed in Indian urology until very recently: the precision of VIU, with the use of autologous cells (cultured adult buccal epithelial cell preparation). Two weeks before surgery, a strip of tissue was taken from inside the patient’s cheek, done under local anaesthesia. Those buccal mucosal cells were packaged and sent to a laboratory in Mumbai. The cells were cultured, multiplied, and prepared into a specialised biological preparation called XTIKTR, containing the patient’s own adult epithelial cells in a coagulant matrix. Mr Chanakya underwent a Visual Internal Urethrotomy (VIU), an endoscopic incision of the stricture, and immediately after, XTIKTR is injected directly into the treated area. This formed a biological scaffold that prevents scar tissue reformation and instead helps the issue to regenerate normally, reducing the recurrence rate. Dr Ravishankar J C noted, “This technique is new to Indian urology and only a few specialized centres in India have adopted it so far. It gives us the results of open surgery with the recovery profile of an endoscopic procedure. That is a major leap for patients with strictures who would otherwise face either repeated VIUs or a major operation.” As for Mr.Chanakya, he recovered without complication and was discharged the next day. He will be monitored every 6 months to assess for any signs of recurrence as per protocols.