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The Role of 3DP Phantoms and Devices for Organ-specified Appliances in Urology
A penile surface mold brachytherapy technique in surgical decision-making and preparation for difficult
using a custom 3D-printed high-dose-rate (HDR) cases in urology field, undoubtedly to avoid any adverse
brachytherapy applicator and its clinical outcome in effects [77,78] .
an early patient cohort was identified by D’Alimonte However, the use of 3DP technology in the
et al. This approach gave the patient a non-invasive development of urological models, phantoms, and
ambulatory procedure with minimal pain during each appliances requires thorough and comprehensive
application. This choice made the opportunity to imagine strategies. In terms of value for money, the selection of
the treatment with simple applicators on the setup an 3D printer must be considered meticulously since each
alternative to current approaches to treatment . type of 3D printers has its own trade-off. For instance,
[72]
the purchase of SLA 3D printer may deliver smoother
(2) Penile reconstruction
and more delicate products with faster production time
Yu et al. indicated that for tunica albuginea replacement, compared to extrusion printers. However, the price for
3D-printed polycaprolactone (PCL) scaffolds seeded with one unit of SLA 3D printer is relatively more expensive
fibroblast cells would be feasible. The tensile strength of than one unit of extrusion printer, as well as their
a scaffold built with an oblique pattern will be greater. consumable goods. In this case, a urology research center
The biocompatibility and strength of two kinds of PCL should define the preference, whether the delicacy of the
scaffolds built using a 3D bioprinting technique were 3D products or cost efficiency .
[78]
assessed in this preliminary analysis. All the scaffolds had In terms of technological aspects, urologists do not
a well-defined architecture and a homogeneous porous have adequate experience to segment medical images
structure, based on their findings. Fibroblast cells were and print 3D models of patient anatomy. Therefore, it is
well attached, proliferated, and differentiated in the PCL important for the urologists to collaborate with engineers
scaffolds. These findings indicate that 3D-printed PCL in the field of 3D modeling and 3D printing technology.
scaffolds may be used for tissue engineering applications Such collaboration may strengthen both clinical and
in the field of sexual medicine . technical aspects of the 3D models, phantoms, and
[73]
5.7. Adrenal appliances.
Material selection in 3DP is not always
(1) Adrenalectomy straightforward. For example, for truly mimicking soft
Partial adrenalectomy (PA) as a key in managing adrenal tissues, especially the mechanical properties, 3DP requires
gland diseases still has weaknesses. When doing a partial flexible materials. However, flexible materials, such as
resection, there was a risk of tumor recurrence and the thermal polyurethane (TPU) and thermoplastic elastomer
patient may also require hormone replacement. To (TPE), are not easy to proceed. Pre-adjustment processes
achieve good functional results after a PA, determining are needed. Apart from this issue, some materials require
the resection limit and the volume of the residual gland is post-processing to be fully biocompatible. In addition,
therefore important. some materials cannot withstand sterilization procedures,
Srougi et al. reported a successful partial such as autoclave sterilization. Polylactic acid (PLA) is
adrenalectomy using a pre-operative 3D-printed model. one of the materials that failed to preserve its integrity due
Neither intraoperative nor post-operative complications to high temperature and high pressure of an autoclave.
were present. The operation time was 190 min, In addition, specific regulation guidelines are still
with bleeding estimated at < 50 ml. This single case rarely enforced and limited in the usage of customized
demonstrates a new technique that could maximize the 3D-printed medical devices, which may contribute to
functional effects of a partial adrenalectomy . medical misconducts [19,78] .
[74]
6. Discussion 7. Conclusion

A new era of clinical treatments has been created by 3D printing technology may bring remarkable changes
relatively recent discoveries in imaging and surgical in medical fields, and particularly in for the phantom
system technology at the hands of urologists and the and device development of organ-specified appliances
concurrent growth of 3DP technology has contributed in urology. Nevertheless, further studies are needed
to its incorporation into other areas of urological care. to explore broader knowledge about the desirable
To the best of our knowledge, this review is the first to functionalities and clinical outcomes of 3D-printed
present and discuss the application of 3DP technology materials and products. As 3DP technology continues to
in every urinary system organ. 3DP is a rapidly evolving grow the potential of personalized surgery from research
new technology which has shown great promise in the institutions to regular urological practice, the years ahead
medical and surgical fields. This may be most important will be an exciting time.

10 International Journal of Bioprinting (2021)–Volume 7, Issue 2