Human urinary bladder regeneration through tissue engineering – An analysis of 131 clinical cases

Abstract

Replacement of urinary bladder tissue with functional equivalents remains one of the most challenging problems of reconstructive urology over the last several decades. The gold standard treatment for urinary diversion after radical cystectomy is the ileal conduit or neobladder; however, this technique is associated with numerous complications including electrolyte imbalances, mucus production, and the potential for malignant transformation. Tissue engineering techniques provide the impetus to construct functional bladder substitutes de novo. Within this review, we have thoroughly perused the literature utilizing PubMed in order to identify clinical studies involving bladder reconstruction utilizing tissue engineering methodologies. The idea of urinary bladder regeneration through tissue engineering dates back to the 1950s. Many natural and synthetic biomaterials such as plastic mold, gelatin sponge, Japanese paper, preserved dog bladder, lyophilized human dura, bovine pericardium, small intestinal submucosa, bladder acellular matrix, or composite of collagen and polyglycolic acid were used for urinary bladder regeneration with a wide range of outcomes. Recent progress in the tissue engineering field suggest that in vitro engineered bladder wall substitutes may have expanded clinical applicability in near future but preclinical investigations on large animal models with defective bladders are necessary to optimize the methods of bladder reconstruction by tissue engineering in humans.

Neurogenic bladder in spinal cord injury patients

“…Although the idea was conceived in the 1950s, and a plethora of natural and synthetic biomaterial scaffolds has been used in experimental animals, their clinical application remains a formidable challenge 139. In a meta-analysis of 28 preclinical and two clinical studies, the reviewers found a poor correlation between the initial experimental successes in healthy animals and those reported in clinical trials 140.…”

Are agricultural and natural sources of bio-products important for modern regenerative medicine? A review

“…More recently, it has been suggested that it could be employed to promote bladder regeneration after cancer of this tissue. Certainly, there is the possibility of using such material as a biologically tolerated matrix in experimental cell transplantations [15].…”

The histocompatibility research of hair follicle stem cells with bladder acellular matrix

“…Traditional bladder tissue repair materials contain an autologous nonurinary system, such as gastrointestinal tract tissue, and synthetic polymers or nature derivative materials, such as poly hydroxy acetic acid and collagen. [1] Recent tissue engineering researches of bladder repair and reconstruction have got a remarkable progress. [2] The establishment of tissue engineering bladder is mainly based on 3 major technologies that are the appropriate seed cells, the appropriate scaffold materials, the implantation of seed cells with scaffold materials and induced into target tissue or organ.…”