Abstract:
Introduction: Percutaneous nephrostomy (PCN) is a crucial intervention for urinary tract
decompression in obstructive uropathy, malignancy, and infection. However, it carries significant
risks, including hemorrhage, infection, and catheter dysfunction. Moderate hematuria occurs in 50%
of cases, while severe bleeding requiring transfusion is reported in 1–4% of patients. Long-term
catheter-related complications, such as occlusion and dislodgement, affect nearly 50% of patients,
often leading to recurrent infections and renal impairment. Given these risks, regenerative medicine
approaches, including stem cell therapy and tissue engineering, are being explored as alternative
solutions.
Materials and Methods: Experimental studies demonstrate that mesenchymal stem cells (MSCs)
migrate to injured bladder and renal tissues, reducing fibrosis and promoting tissue repair. In animal
models, MSC administration improves vascularization, decreases hypoxia, and enhances bladder
compliance. Additionally, acellular matrices and biomaterial scaffolds provide structural support,
facilitating cell adhesion, migration, and differentiation. These scaffolds can be functionalized with
growth factors to further enhance regenerative processes.
Results: Research indicates that MSC-based therapy reduces fibrosis and enhances bladder function
in urinary obstruction. Tissue-engineered constructs incorporating MSCs and biomimetic scaffolds
promote urothelial regeneration, smooth muscle reconstruction, and reduced catheter dependency. The
use of bioactive scaffolds improves biocompatibility, minimizes inflammatory responses, and
mitigates complications such as infections and occlusions.
Conclusion: Stem cell therapy and biomaterial-based scaffolds offer promising strategies for
addressing PCN-associated complications. Further studies should focus on refining cell delivery
methods, optimizing scaffold design, and validating their clinical efficacy. The integration of
regenerative therapies into standard PCN management may reduce the morbidity associated with
catheter-based interventions and improve long-term patient outcomes.
