Current Applications and Future Directions of Bioengineering Approaches for Bladder Augmentation and Reconstruction

Abstract

End-stage neurogenic bladder usually results in the insufficiency of upper urinary tract, requiring bladder augmentation with intestinal tissue. To avoid complications of augmentation cystoplasty, tissue-engineering technique could offer a new approach to bladder reconstruction. This work reviews the current state of bioengineering progress and barriers in bladder augmentation or reconstruction and proposes an innovative method to address the obstacles of bladder augmentation. The ideal tissue-engineered bladder has the characteristics of high biocompatibility, compliance, and specialized urothelium to protect the upper urinary tract and prevent extravasation of urine. Despite that many reports have demonstrated that bioengineered bladder possessed a similar structure to native bladder, few large animal experiments, and clinical applications have been performed successfully. The lack of satisfactory outcomes over the past decades may have become an important factor hindering the development in this field. More studies should be warranted to promote the use of tissue-engineered bladders in clinical practice.

Application of 3D Bioprinting in Urology

“…At the same time, 3D bioprinting technology is also a multidisciplinary cross-application technology, requiring the integration of cell biology, computers, materials, information, chemistry, mechanics, engineering, manufacturing, medicine and other scientific and technological fields of talent. At present, there are still some technical difficulties in 3D bioprinting technology, and only through continuous research breakthroughs will it be possible to apply 3D bioprinting to a wide range of clinical applications and bring benefits to patients [ 6 , 15 , 16 , 106 , 107 ].…”

Biodegradable polyurethane scaffolds in regenerative medicine: Clinical translation review

“…Multiple reviews of bladder pathologies and repair strategies are available for a more in-depth analysis of current care strategies and newer regenerative approaches. [198][199][200] Most strategies using sources of autologous tissue other than the intestines, naturallyderived biomaterials, or synthetic biomaterials, have been largely…”

“…This has traditionally been done using autologous intestinal tissue, and is still the standard of care today. Multiple reviews of bladder pathologies and repair strategies are available for a more in‐depth analysis of current care strategies and newer regenerative approaches 198–200 . Most strategies using sources of autologous tissue other than the intestines, naturally‐derived biomaterials, or synthetic biomaterials, have been largely unsuccessful in both pre‐clinical and clinical applications long‐term, with the exception noted above of the PGA‐collagen device described by Atala et al 195 The objectives for successful repair using a scaffold approach would include maintenance of mechanical compliance and bladder capacity without graft shrinkage or leakage, and cell proliferation across the surface of the scaffold.…”

The Comparative Effectiveness of Botulinum Toxin-A Injection Therapy Versus Augmentation Uretero-Enterocystoplasty for the Treatment of Lower Urinary Tract Dysfunction

“…Augmentation uretero-enterocystoplasty (AUEC), a type of augmentation cystoplasty (AC) performed simultaneously with ureteroplasty and antireflux reimplantation, is an option for patients with UUT deterioration [ 3 ]. However, this procedure can involve complications [ 4 ], such as metabolic disturbances, urolithiasis, and even malignancy.…”