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The Role of 3DP Phantoms and Devices for Organ-specified Appliances in Urology
can effectively relieve symptoms of stress urinary leads to underdiagnosis of clinically important disease.
incontinence (SUI). The secret to symptom enhancement Wang et al. utilized 3DP technology to help early prostate
is proper mechanical fit. Barsky et al. announced that cancer diagnosis, which dramatically increased the rate of
a personalized 3D-printed pessary was successfully biopsy and avoided missed diagnosis of high-risk prostate
implanted into an SUI patient. 3DP permits an cancer. The 3D printing technique accurately replicates
anatomically compatible pessary that can be generated the 3D image and shows the tumor’s location, size, and
reproducibly . morphology intuitively by adding clear resin materials .
[57]
[62]
(3) Bladder cancer (2) Prostatectomy
Neobladder after radical cystectomy is the gold standard Porpiglia et al. tested the face and content validity on the
method for urinary diversion. However, various use of 3D-printed prostate cancer models before robot-
complications, such as mucus development, electrolyte assisted radical prostatectomy. The models displayed
imbalances and increased potential for malignant the prostatic glands, the cancer and the neurovascular
transformation, are associated with these techniques. bundles (NVB) configuration. Before performing live
Bladder-preserving treatments such as radio and prostatectomy surgery at the 5 Techno-Urology Meeting,
th
chemotherapy are also often promoted in the interest of surgeons appeared on the screen with a live audio link
the quality of life of the patients. Tissue engineering has to the auditorium with the 3D-printed models in their
concentrated on the reconstruction of bladder tissue over the hands, enabling provokers, moderators, and attendants
past two decades, and substantial progress has been made to actively participate in the surgical training. Surgeons
in this area [58,59] . In the meantime, 3D printing just found and congress participants filled out the F&C Validity
its role in the post-operative evaluation of a novel Y-pouch Questionnaire, made of open-ended questions of ten-
neobladder, as reported by Bejrananda et al. The 3D-printed point ranking Likert scales. Analysis of the collected
neobladder model enabled evaluation for structural and 144 questionnaires showed a good result regarding both
functional reconstructive outcomes of the neobladder . surgical planning and anatomical accuracy. It means that
[60]
Kim et al. had developed a 3D-printed cancer cell 3DP technology was considered to be a useful tool in
culture environment that successfully demonstrated surgical planning strategy .
[63]
a similar basal action and cell-to-cell interaction with Shin et al. proved the concept by building five
which could be seen in the in vivo environment. This translucent 3D-printed prostate cancer models that
3D-cultured cancer cells exhibited higher resistance and visualized the location, size, and extent of the index cancer
lower sensitivity to chemotherapy than the 2D-cultured lesion. The life-size reality of the models made surgeons
cancer cells. These findings showed that 3DP may understand the distance or proximity of the index lesion,
improve bladder cancer treatment by allowing a more the prostate capsule, and NVB more readily. Accurate
accurate drug response evaluation as well as prediction of concordance between the models and the histological
specific personal responses to drugs . index lesion location and extension resulted in negative
[61]
Lurie et al. developed a 3D cancerous bladder margins . This result was in accordance with the
[64]
phantom with multiple features, including the macroscale IDEAL Phase 2a study outcome conducted by Chandak
structure, microscale topology, subsurface microstructure, et al. Individuals with limited experience, such as
[65]
optical characteristics, optical properties, and size surgical trainees, would find the prostate cancer models
(Figure 3B) . Using 3DP for the molds and spin-coating (Figure 3D) more comprehensible compared to MRI .
[62]
[66]
of polydimethylsiloxane (PDMS) for the phantom
fabrication, the irregular structure of the phantom could 5.4. Ureter
be generated. The used techniques and materials resulted (1) Ureteral stents
in a bladder phantom that could model realistic imaging
conditions, either with optical coherence tomography Stent size selection is of importance as an incorrect
(OCT) or white light cystoscopy (WLC), of bladder selection of stent length election may lead to urinary
cancers . discomfort, voiding symptoms, and stent migration. Del
[62]
Junco et al. characterized the flow characteristics of a novel
5.3. Prostate 3D-printed ureteral stents with the conventional Double-J
(DJ) stents in an ex vivo porcine model. Although several
(1) Prostate biopsy
limitations were found, their results demonstrated that the
The primary alternative for diagnosing prostate cancer mean total flow rates represented by the 3D-printed stents
is transrectal ultrasound (TRUS) guided prostate biopsy. were comparable to the conventional stents. Continued
With existing conventional approaches, however, prostate technological and material advances will allow for a
sampling at the anterior, midline, and apex sections often functional ureteral 3D-printed stent .
[67]
8 International Journal of Bioprinting (2021)–Volume 7, Issue 2