BHES-HAUS: A Simplified Hybrid Approach to Treat Urethral Stricture

BHES-HAUS (Buccal Epithelium Hashed and Encapsulated in Scaffold – Hybrid Approach to Urethral Stricture) is a simplified adaptation of the BEES-HAUS (Buccal Epithelium Expanded and Encapsulated in Scaffold – Hybrid Approach to Urethral Stricture) method. Both techniques aim to engraft buccal mucosal epithelial cells from the patient onto the urethrotomy wound site, which after Direct Visual Internal Urethrotomy (DVIU) is otherwise left to heal naturally, often leading to recurrence. In the BEES-HAUS method, in-vitro cultured buccal epithelial cells are transplanted after expansion, which has already demonstrated successful epithelial engraftment in preclinical studies and promising outcome in a clinical study.

In BHES-HAUS, instead of culturing the tissue, small hashed pieces of buccal mucosa are encapsulated in the Festigel scaffold and applied directly to the urethrotomy site. This approach is inspired by earlier techniques, including the one reported by Nikolavsky et al who used fibrin glue for transplant. Festigel is a synthetic biocompatible scaffold which has been earlier reported with transplantation of tissue bits encapsulated in it allowing cells from its edges to migrate out, proliferate on the cadaver cornea to form a multilayered epithelium on the ocular surface.

Key Advantages of BHES-HAUS Over BEES-HAUS

  1. No GMP compliant Cell Culture Facility Required: The entire procedure can be performed within the operating room itself.
  2. No Need for Specialized Cell Culture Technicians: The urologist can independently perform the complete procedure.
  3. Single-Sitting Treatment: Unlike BEES-HAUS, which requires separate visits for buccal tissue harvest and transplant, BHES-HAUS is completed in a single-sitting.
  4. No 14-Day Cell Expansion Period: Since cell culture is not required, treatment occurs in the same sitting.
  5. Significant Reduction in Cost and Patient Burden: By eliminating cell culture and multiple hospital visits, overall costs and economic burden are greatly reduced for both the patient and the healthcare system.

 

 

For more details on BEES-HAUS procedure, click here https://www.ncrm.org/myth/beeshaus/

 

 

PUBLICATIONS ON BHES-HAUS


1. Horiguchi A, Vaddi S, Rajappa S, Preethy S, Abraham SJK. BEES-HAUS preventing urethral stricture recurrence by restoring the integrity of urothelium and its further simplified version, the BHES-HAUS. Front Bioeng Biotechnol. 2025 Nov 27;13. doi: 10.3389/fbioe.2025.1687741.