This study presents a single-center experience spanning three decades in regenerative urology, focusing on the decellularization, recellularization, grafting, and transplantation of urological tissues and organs. Our research encompasses the kidney, bladder, penile tissue, testis, vas deferens, prostate, ureter, uterus, ovary, corpus spongiosum, urethra, anal sphincter, and adrenal gland. Through experimental models and translational approaches, we aim to develop novel regenerative strategies for urological reconstruction and functional restoration.

We will outline key regenerative techniques based on their development timeline. This includes:

	•	Bladder augmentation using decellularized tissues, from gallbladder-derived scaffolds to advanced cell-sheet engineering.
	•	Penile tissue regeneration via total decellularized penile grafts for elongation in a sheep model
	•	Anal sphincter reconstruction in rabbits using decellularized sphincter grafts, with and without satellite cells, for fecal incontinence treatment.
	•	Female stress urinary incontinence (SUI): Phase I clinical trials following extensive preclinical studies to create a urethral deficiency model and develop a novel human extracellular matrix.
	•	Testicular tissue engineering: Implantation of human testis extracellular matrix in C57BL/6 mice to induce seminiferous tubule recellularization. Additionally, we explore spermatogonial stem cell expansion through microfluidic scaffolds and in vivo models.

Our research highlights significant advancements in regenerative strategies, demonstrating the potential of decellularized scaffolds combined with autologous or allogeneic stem cells to restore urological function. These approaches have shown promising outcomes in structural integration, cellular repopulation, and functional recovery in preclinical models.

Decellularization provides biocompatible scaffolds that support cell adhesion and tissue regeneration, while recellularization with stem or progenitor cells enhances functional recovery. Our results emphasize the importance of optimizing scaffold properties, cell integration, and host responses to improve clinical applications. This focuses on the cutting-edge approaches and strategies created over time to improve the regeneration of these essential components. We hope to enhance functional results in urological therapies and ultimately aid in better patient care and recovery by combining cutting-edge decellularization and recellularization techniques.

Regenerative urology, leveraging autologous stem cell transplantation and tissue engineering, holds immense potential for treating organ and tissue failure. However, before translating these findings into widespread clinical practice, further experimental validation and long-term outcome assessments are essential. By refining these technologies, we move closer to personalized regenerative solutions that improve patient outcomes and quality of life.