Silk Biomaterial Research Advances Urologic Treatment Capabilities

The Urology Center at CHOC Children’s is collaborating with Joshua Mauney, PhD, associate professor of urology/biomedical engineering and Jerry D. Choate Presidential Chair in Urology Tissue Engineering in the University of California, Irvine Urology Department, who focuses his research on tissue engineering with the development of silk biomaterials for the repair of visceral hollow organs. Dr. Mauney has a productive basic science laboratory with NIH grant funding and was previously a staff scientist in the Department of Urology at Boston Children’s Hospital and associate professor of surgery at Harvard Medical School.

“The overall goal is the creation of clinically useful scaffold configurations for hollow organ regeneration by engineering materials which fulfill structural and mechanical requirements of native tissues as well as present microenvironmental cues necessary for host tissue integration and defect consolidation,” said Dr. Mauney.

3D matrix designs using silk biomaterials can be used to restore function related to injury or fibrotic disease. Silk scaffolds offer advantages over non-biomaterial implants for human bladder augmentation and can support bladder storage, voiding function and defect correction.

“The addition of Dr. Mauney allows the CHOC team to focus on the reconstruction of bladders and organs using his 3D matrix designs to offer options for children born with missing or abnormal parts of their urinary tract,” said Dr. Antoine “Tony” Khoury, chief of pediatric urology.

Dr. Tony Khoury, chief of pediatric urology at CHOC
Dr. Tony Khoury, chief of pediatric urology at CHOC

Our Care and Commitment to Children Has Been Recognized

CHOC Children’s Hospital was named one of the nation’s best children’s hospitals by U.S. News & World Report in its 2020-21 Best Children’s Hospitals rankings and ranked in the urology specialty.

US News and World Report, Urology

Learn now CHOC’s urology care, ongoing treatment and surgical interventions preserve childhood for children in Orange County, Calif., and beyond.

CHOC makes advancements for neurogenic bladder patients

The Urology Center at CHOC Children’s has implemented and evaluated a bladder pressure and volume diary for patients at risk for increased intravesical pressures.

“Patients dependent on clean intermittent catheterization used ruler-based manometry to measure intravesical pressures before leakage or scheduled drainage at home,” said Dr. Antoine Khoury, chief of pediatric urology. Patients were asked to record measurements while relaxed in a supine position.

Dr. Antoine Khoury, chief of pediatric urology at CHOC Children's
Dr. Antoine Khoury, chief of pediatric urology at CHOC Children’s

Study results

The study included 30 patients ranging in age from 1 to 20, with a mean age of 10.

“Home pressures measured at maximal clean intermittent catheterization volume and mean bladder pressure/volume diary pressures were most reliable in predicting urodynamic pressures greater than 30 cm water (AUC 0.93 and 0.87, respectively). Home pressures measured at maximal clean intermittent catheterization volumes less than 20 cm water were associated with normal bladder pressures (less than 30 cm water) on urodynamics, with a sensitivity of 100% and a specificity of 80%,” said Dr. Khoury.

To view this study in greater detail, click here.

A bladder pressure/volume diary helps patients monitor pressure at home and reduces the need for frequent video urodynamics (VUDS) or urodynamics (UDS). As a complementary tool to urodynamics, it provides early detection for high bladder pressures that have the potential to cause kidney damage and renal failure.

Our care and commitment to children has been recognized

CHOC Children’s Hospital was named one of the nation’s best children’s hospitals by U.S. News & World Report in its 2020-21 Best Children’s Hospitals rankings and ranked in the urology specialty.

Best Children's Hospitals, U.S. News & World Report, Urology, 2020-21

Learn how CHOC’s urology care, ongoing treatment and surgical interventions preserve childhood for children in Orange County, Calif., and beyond