Cystoplasty by Regeneration of the Bladder

Taguchi, Hirokazu; Ishizuka, Eiichi; Saito, Kiyoshi

doi:10.1016/s0022-5347(17)58181-1

Cited by 34 publications

(17 citation statements)

References 4 publications

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“…It is sometimes reported that the bladder 'regenerates' after a cystoplasty, some centers even use the regenerat ing ability of the bladder in the treatment of contracted bladders by a special cystoplasty using artificial material over which the bladder regenerates [10]. In 1 of our patients (with interstitial cystitis) extensive regeneration of the bladder occurred, which necessitated a revision of the coecocystoplasty.…”

Section: Discussionmentioning

confidence: 79%

Coecocystoplasty: An Evaluation of Operative Results

Holm-Bentzen¹,

Klarskov²,

Opsomer³

et al. 1986

Urol Int

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Coecocystoplasty for substituting or augmenting the bladder is a relatively common operation in the United States, but not in Scandinavia. In order to focus the attention on this voiding-preserving operation we evaluated the late postoperative results of 8 patients. Median follow-up was 5 years. Seven of the patients had symptoms from a contracted bladder and 1 patient with epispadias was undiverted from a ureteroileocutaneostomy. There were some early postoperative complications. Two patients had a revision of the coecocystoplasty, 1 patient ended up with a ureteroileocutaneostomy and 1 patient needed a nephrectomy because of a perirenal abscess. The patient with epispadias later had an artificial urinary sphincter because of persisting incontinence. At follow-up time all patients found that they had a better life than prior to operation since the invalidating symptoms from the contracted bladder had disappeared. One patient with residual urine had chronic urinary tract infection. All patients were continent at daytime, 3 patients had nocturnal incontinence. Urodynamic studies showed no infravesical obstruction and bladder capacity between 75 and 380 ml H₂O. Three patients had decreased renal function. Based on our limited material we conclude that coecocystoplasty is a reasonable, though not unproblematic, treatment in patients with severe symptoms from a small contracted bladder and a therapeutical alternative in patients with a previously defunctionalised bladder and that this method should always be taken into consideration before a urinary diversion.

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Section: Discussionmentioning

confidence: 79%

Coecocystoplasty: An Evaluation of Operative Results

Holm-Bentzen¹,

Klarskov²,

Opsomer³

et al. 1986

Urol Int

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“…[2][3][4][5][6][7][8] The earliest clinical trials of bladder augmentation by biomaterials were performed in the 1960s and 1970s for bladders after partial cystectomy for invasive bladder cancer, or for contracted bladders due to tuberculosis, which was still prevalent in many countries. 9,10 Thus, it is not surprising that such an approach lost clinical and academic impact during the 1980s and early 1990s, when urinary tuberculosis had nearly disappeared in developed countries, and total cystectomy was established as the standard surgical therapy for invasive cancer. During the same period , the evolution in continent reservoir and neobladder using the digestive tract was so radical that bladder substitution by nonautologous tissue may not have been felt as keenly needed as earlier.…”

Section: Introductionmentioning

confidence: 99%

Changing concepts of bladder regeneration

2007

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During the last decade, there has been a dramatic increase in studies aimed at regeneration of the urinary bladder. Many studies employed animal-derived or synthetic materials as grafts for experimental bladder augmentation models, with or without additional measures to promote regeneration, such as autologous cell transplantation or growth factor loading. However, in spite of encouraging results in several reports, few methodologies have shown proven definitive clinical utility. One major problem in these studies is the lack of a clear distinction between native and regenerated bladder in total bladder function after augmentation. Another crucial problem is the absorption and shrinkage of larger grafts, which may result from insufficient vascular supply and smooth muscle regeneration. In contrast, researchers have recently attempted to establish alternative regenerative strategies for treating bladder diseases, and have employed far more diverse approaches according to the various pathological conditions to be treated. For total replacement of the bladder after cystectomy for invasive bladder cancer, urothelium-covered neobladder with non-urinary tract backbone remains a viable choice. In addition, functional bladder diseases such as urinary incontinence, weak detrusor, or non-compliant fibrotic bladder have also been major targets for many leading research groups in this field. These conditions are studied much more from different therapeutic standpoints, aiming at the prevention or reversal of pathological conditions in muscle remodeling or neural control. Such altered research direction would inevitably lead to less surgically based basic biological research, and also would include a far wider spectrum of adult and pediatric bladder diseases, from overactive bladder to dysfunctional voiding.

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“…However, the fact that gelatin sponge has not been used since then in further clinical trials of bladder augmentation indicates skepticism about the reliability of the presented results. These doubts have been confirmed by Taguchi et al [127] who showed that the gelatin sponge disintegrated into small pieces in vivo. In combination with nobecutane it formed synthetic resin-like structures and did not degrade, forming calculi in the tissue.…”

Section: Clinical Bladder Tissue Engineeringmentioning

confidence: 88%

Stem Cells in Functional Bladder Engineering

Smolar

Salemi

Horst

et al. 2016

Transfus Med Hemother

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Conditions impairing bladder function in children and adults, such as myelomeningocele, posterior urethral valves, bladder exstrophy or spinal cord injury, often need urinary diversion or augmentation cystoplasty as when untreated they may cause severe bladder dysfunction and kidney failure. Currently, the gold standard therapy of end-stage bladder disease refractory to conservative management is enterocystoplasty, a surgical enlargement of the bladder with intestinal tissue. Despite providing functional improvement, enterocystoplasty is associated with significant long-term complications, such as recurrent urinary tract infections, metabolic abnormalities, stone formation, and malignancies. Therefore, there is a strong clinical need for alternative therapies for these reconstructive procedures, of which stem cell-based tissue engineering (TE) is considered to be the most promising future strategy. This review is focused on the recent progress in bladder stem cell research and therapy and the challenges that remain for the development of a functional bladder wall.

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Cystoplasty by Regeneration of the Bladder

Cited by 34 publications

References 4 publications

Coecocystoplasty: An Evaluation of Operative Results

Coecocystoplasty: An Evaluation of Operative Results

Changing concepts of bladder regeneration

Stem Cells in Functional Bladder Engineering

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