Experience with Urinary Bladder Regeneration

Bohne, A. Waite; Urwiller, K.L.

doi:10.1016/s0022-5347(17)66624-2

Cited by 65 publications

(26 citation statements)

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“…1 However, a truly continuous attempt at bladder regeneration took place about 40 years after that report, beginning with the experiments by Bohne. [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.…”

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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Section: Introductionmentioning

confidence: 99%

Changing concepts of bladder regeneration

2007

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“…[4][5][6][7][8] Collagenrich biodegradable materials such as placenta, amnion and pericardium have been used with more success than nonbiodegradable materials. [9][10][11][12] However, none of these materials has been found to be suitable for clinical use.…”

Section: Discussionmentioning

confidence: 99%

Penile enhancement using a porcine small intestinal submucosa graft in a rat model

2005

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Several biodegradable materials have been experimented for penile enhancement, but none show the potential for clinical use. This study was designed to use porcine small intestinal submucosa (SIS) augmenting the normal tunica albuginea to increase the functional girth of the rat penis. In all, 20 adult male Sprague-Dawley rats constituted the study population. The animals were divided into two groups: group 1 consisted of the control (n ¼ 10) and group 2 (n ¼ 10) consisted of rats that underwent penile enhancement by a longitudinal I-shaped incision of the tunica albuginea on both sides, and the dissection of the plane between tunica albuginea and cavernosal tissue was carried out (n ¼ 10). The incision was then patched with a 3 Â 10 mm 2 piece of SIS, using a 6/0 nylon suture material. The penile length and mid-circumference were then measured using a Vernier Caliper before and 2 months after surgery. All rat penises underwent histological examination using Masson's trichome and Verhoff's van Giesen's stain for collagen and elastic fibers. The penile length, mid-circumference and degree of fibrosis score were expressed as mean7s.e. (standard error) and analyzed using a Wilcoxon rank-sum test. A statistical significance was accepted at P-value p0.05. Our results showed similar preoperative penile length and circumference in both groups. However, 2 months after the surgery, the mean penile circumference of the SIS group has grown significantly larger than the control group, while the mean penile length remained unchanged. The histological study of the rat penises revealed minimal amounts of fibrosis under the graft, and the elastic fibers of the graft showed orientation in a circular manner. In conclusion, SIS appears promising for material use in a penile enhancement.

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“…Bladder TE has seen its first successful clinical implementation in the late 1950s [121]. Two major approaches have been developed over the years so far, the first of which utilizes the use of natural or synthetic scaffolds alone with the idea to support native cell ingrowth and thus the regeneration of the bioengineered tissue/scaffold, while the second approach includes combinations of autologous cells and biomaterials.…”

Section: Clinical Bladder Tissue Engineeringmentioning

confidence: 99%

“…These new bladders consisted mainly of fibrotic tissue leading to various complications without functional tissue regeneration [121,122,123,124]. …”

Section: Clinical Bladder Tissue Engineeringmentioning

confidence: 99%

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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Experience with Urinary Bladder Regeneration

Cited by 65 publications

References 0 publications

Changing concepts of bladder regeneration

Changing concepts of bladder regeneration

Penile enhancement using a porcine small intestinal submucosa graft in a rat model

Stem Cells in Functional Bladder Engineering

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