Future Perspectives in Bladder Tissue Engineering

Abstract

Substantial clinical need persists for improved autologous tissues to augment or replace the urinary bladder and research has begun to address this using tissue engineering techniques. The implantation of both tissue scaffolds which allow for native bladder tissue ingrowth and autologous bladder grafts created from in vitro cellularization of such scaffolds have been tested clinically; however, successful outcomes in both scenarios have been challenged by insufficient vascularity resulting from large graft sizes, which subsequently limits tissue ingrowth and leads to central graft ischemia. Consequently, recent research has focused on developing better methods to produce scaffolds with increased tissue ingrowth and vascularity. This review provides an update on bladder tissue engineering and outlines the challenges that remain to clinical implementation.

Whyever bladder tissue engineering clinical applications still remain unusual even though many intriguing technological advances have been reached?

“…Moreover, promising chances of cell-seeded bladder engineering may be achieved by the resort to pluripotent or multipotent stem cells (Table 2), capable of selfrenewal together with properly guided differentiation in tissue-specific cell lineages, such as particularly both urothelial and smooth muscle cells (13,(45)(46)(47).…”

“…Notwithstanding the great development of tissue engineering technologies, current clinical applications are unusual, many research challenges still remaining open (13).…”

“…Reliable reasons why bladder tissue engineering clinical applications so far are unusual, imply the significant risk of possible serious complications -particularly graft ischemia, hence its both fibrous contraction and even worse perforation -obviously due to limited postimplanted graft vascularity (12,13).…”

Mechanical reinforcement of urinary bladder matrix by electrospun polycaprolactone nanofibers

“…Biomaterials in the bladder tissue engineering are biological materials, such as acellular tissue matrices [10,11], derived from natural sources or synthetic polymers, such as polycaprolacton (PCL) [7,12], using various fabrication techniques such as electrospinning, solvent casting, particulate leaching, 3D printing, gas foaming, phase separation, and freeze drying [9,[13][14][15][16]. Incorporation of both biological and synthetic materials along with the goal of reinforcing matrices' mechanical properties and optimizing biological properties has been proposed in previous studies [12].…”

“…Incorporation of both biological and synthetic materials along with the goal of reinforcing matrices' mechanical properties and optimizing biological properties has been proposed in previous studies [12].…”