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Human organ replacement is limited by a donor shortage, problems with tissue compatibility, and rejection. Creation of an organ with autologous tissue would be advantageous. In this study, transplantable urinary bladder neo-organs were reproducibly created in vitro from urothelial and smooth muscle cells grown in culture from canine native bladder biopsies and seeded onto preformed bladder-shaped polymers. The native bladders were subsequently excised from canine donors and replaced with the tissue-engineered neo-organs. In functional evaluations for up to 11 months, the bladder neo-organs demonstrated a normal capacity to retain urine, normal elastic properties, and histologic architecture. This study demonstrates, for the first time, that successful reconstitution of an autonomous hollow organ is possible using tissue-engineering methods.

A guidelines text is presented including chapters on prostate pain and bladder pain syndromes, urethral pain, scrotal pain, pelvic pain in gynaecological practice, role of the pelvic floor and pudendal nerve, general treatment of chronic pelvic pain and neuromodulation. These guidelines have been drawn up to provide support in the management of the large and difficult group of patients suffering from chronic pelvic pain.

Very little is known about the basal cells in the epididymal epithelium. Their function is unclear, although they are present in all mammalian epididymides studied. The corpus epididymides from five patients undergoing castration because of prostatic carcinoma were fixed and processed for electron microscopy. Basal cells were characterized by a slightly heterochromatic nucleus with prominent nucleolus, pale round mitochondria, dispersed endoplasmic reticulum, and sparse Golgi apparatus; they were often rich in lipofuscin inclusions, possibly originating from principal cells. Some peritubular macrophages in close proximity to the epithelium were structurally similar to basal cells. Immunohistochemical staining revealed in the epididymides of another ten patients that the basal cells were recognized by the monoclonal antibody (mAb) 25F9 against mature, tissue-fixed macrophages but not by mAbs 27E10 or RM3/1, which were against activated macrophages usually found in acute or late inflammation, respectively. On the basis of the present findings, as a working hypothesis a scavenging role of the basal cells in a local immune defense mechanism is proposed, in which antigenic products (possibly of sperm degradation), taken up by the principal cells, would be phagocytosed by the basal cells. It could be inferred that when the basal cells are overloaded, they would leave the epithelium to be replenished by tissue-fixed macrophages.

It has been established in laboratory mammals that sperm motility and fertilizing capacity develop during epididymal transit, but sperm maturation along the human epididymis is less well characterized. Spermatozoa were prepared from 5 regions of 8 epididymides from 8 prostatic carcinoma patients undergoing castration and from 8 epididymal spermatocoeles located adjacent to the head of the epididymides and the testes of 5 patients. Sperm movement was characterized by computer-aided sperm analysis (CASA), and percentage motility was estimated by conventional methods. The efferent ducts and spermatocoeles contained the same percentage of motile spermatozoa with similar kinematics. Percentage motility increased from 22.9 +/- 4.8 (mean +/- SEM) in the efferent ducts to a maximum of 68.3 +/- 7.9 in either the mid- or distal corpus epididymidis and declined in the cauda region. Straight line velocity increased from 20.3 +/- 3.7 microns/sec to reach a plateau value of 44.0 +/- 5.3 microns/sec in the mid-corpus epididymidis; this was more marked than the increase in curvilinear velocity, although the trend was the same. Similar trends in linearity and straightness of the swim paths were not accompanied by any significant changes in the amplitude of lateral head displacement. This objective quantification of sperm movement documents the maturation of sperm motility in the human epididymis, confirming that this maturation pattern is similar to that in other mammals.

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