10 April 2014
Last updated at 20:45 ET
Doctors implant lab-grown vagina
Scans of the pelvic region were used to design a tube like 3D-scaffold for each patient
Four women have had new vaginas grown in the laboratory and implanted by doctors in the US.
They all reported normal levels of "desire, arousal, lubrication, orgasm, satisfaction" and painless intercourse.
Experts said the study, published in the Lancet, was the latest example of the power of regenerative medicine.
'I feel fortunate'
In each woman the vagina did not form properly while they were
still inside their mother's womb, a condition known as vaginal aplasia.
Current treatments can involve surgically creating a cavity, which is then lined with skin grafts or parts of the intestine.
Doctors at Wake Forest Baptist Medical Centre in North Carolina
used pioneering technology to build vaginas for the four women who were
all in their teenage years at the time.
Scans of the pelvic region were used to design a tube like 3D-scaffold for each patient.
A small tissue biopsy was taken from the poorly developed vulva and grown to create a large batch of cells in the laboratory.
The vaginas were carefully grown in a bioreactor until they were suitable to be surgically implanted into the patients.
One of the women with an implanted vagina, who wished to keep her name anonymous, said: "I believe in the beginning when you find out you feel different.
"I mean while you are living the process, you are seeing the possibilities you have and all the changes you'll go through.
"Truly I feel very fortunate because I have a normal life, completely normal."
'An important thing'
Current treatments can involve surgically creating a cavity, which is then lined with skin grafts or parts of the intestine.
The scaffold is made of a biodegradable material
Scans of the pelvic region were used to design a tube like 3D-scaffold for each patient.
A small tissue biopsy was taken from the poorly developed vulva and grown to create a large batch of cells in the laboratory.
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There are even attempts to make more complex organs. Weakly beating hearts and kidneys that can produce urine have been made in animal studies. But this is still a long way from being used in humans.
Expect 3D printing to revolutionise this field as the technology to precisely place both the cells and the scaffolding improves.
Analysis
This is an exciting glimpse into the future of medicine. Using living tissue as building material to transform the lives of patients has already happened with bladders, blood vessels and windpipes. Now you can add vaginas and noses to the list.There are even attempts to make more complex organs. Weakly beating hearts and kidneys that can produce urine have been made in animal studies. But this is still a long way from being used in humans.
Expect 3D printing to revolutionise this field as the technology to precisely place both the cells and the scaffolding improves.
Muscle cells were attached to the outside of the scaffold and vaginal-lining cells to the inside.
One of the women with an implanted vagina, who wished to keep her name anonymous, said: "I believe in the beginning when you find out you feel different.
"I mean while you are living the process, you are seeing the possibilities you have and all the changes you'll go through.
"Truly I feel very fortunate because I have a normal life, completely normal."
'An important thing'
All the women reported normal sexual function.
Vaginal aplasia can lead to other abnormalities in the reproductive organs, but in two of the women the vagina was connected to the uterus.
There have been no pregnancies, but for those women it is theoretically possible.
Dr Anthony Atala, director of the Institute for Regenerative
Medicine at Wake Forest told the BBC News website: "Really for the first
time we've created a whole organ that was never there to start with, it
was a challenge."
He said a functioning vagina was a "very important thing" for these women's lives and witnessing the difference it made to their lives "was very rewarding to see".
This is the first time the results have been reported, however, the first implants took place eight years ago.
'Most important questions'
Vaginal aplasia can lead to other abnormalities in the reproductive organs, but in two of the women the vagina was connected to the uterus.
There have been no pregnancies, but for those women it is theoretically possible.
The scaffold is placed in an incubator
He said a functioning vagina was a "very important thing" for these women's lives and witnessing the difference it made to their lives "was very rewarding to see".
This is the first time the results have been reported, however, the first implants took place eight years ago.
'Most important questions'
Meanwhile researchers at the University of Basel in
Switzerland have used similar techniques to reconstruct the noses of
patients after skin cancer.
Prof Martin Birchall, who has worked on lab-grown windpipes, commented: "These authors have not only successfully treated several patients with a difficult clinical problem, but addressed some of the most important questions facing translation of tissue engineering technologies.
The steps between first-in-human experiences such as those reported here and their use in routine clinical care remain many, including larger trials with long-term follow-up, the development of clinical grade processing, scale-out, and commercialisation."
The other side of the scaffold is coated with smooth muscle cells before it is incubated a second time
It could replace the need to take cartilage from the ribs or
ears in order to rebuild the damage caused by cutting the cancer away.Prof Martin Birchall, who has worked on lab-grown windpipes, commented: "These authors have not only successfully treated several patients with a difficult clinical problem, but addressed some of the most important questions facing translation of tissue engineering technologies.
The steps between first-in-human experiences such as those reported here and their use in routine clinical care remain many, including larger trials with long-term follow-up, the development of clinical grade processing, scale-out, and commercialisation."
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