The effects of human amniotic fluid stem cell (hAFSC) transplantation on bladder function and molecular changes in spinal cord-injured (SCI) rats were investigated. Four groups were studied: sham and SCI plus phosphate-buffered saline (SCI + PBS), human embryonic kidney 293 (HEK293) cells, and hAFSCs transplantation. In SCI + PBS rat bladders, cystometry showed increased peak voiding pressure, voiding volume, bladder capacity, residual volume, and number of non-voiding contractions, and the total elastin/collagen amount was increased but collagen concentration was decreased at days 7 and 28. Immunoreactivity and mRNA levels of IGF-1, TGF-β1, and β3-adrenoceptor were increased at days 7 and/or 28. M2 immunoreactivity and M3 mRNA levels of muscarinic receptor were increased at day 7. M2 immunoreactivity was increased, but M2/M3 mRNA and M3 immunoreactivity levels were decreased at day 28. Brain derived-neurotrophic factor mRNA was increased, but immunoreactivity was decreased at day 7. HEK293 cell transplantation caused no difference compared to SCI + PBS group. hAFSCs co-localized with neural cell markers and expressed BDNF, TGF-β1, GFAP, and IL-6. The present results showed that SCI bladders released IGF-1 and TGF-β1 to stimulate elastin and collagen for bladder wall remodelling, and hAFSC transplantation improved these changes, which involved the mechanisms of BDNF, muscarinic receptors, and β3-adrenoceptor expression. Spinal cord injury (SCI) affects approximately 2.5 million people worldwide and may cause severe physical disabilities 1. Most patients with SCI develop neurogenic bladder symptoms, including overactive bladder, urinary retention, urinary tract infection, and chronic renal failure 2,3. These neurogenic bladder conditions cause altered tissue morphology, such as bladder hypertrophy 4 and fibrosis 5 , which adversely affect detrusor muscle function and result in bladder of low compliance and capacity 6. Although the effects of SCI on bladder function have been extensively studied, changes in the mechanical behaviour of the SCI bladder wall tissue have not been fully established. Abnormal expression of collagen and elastin in human bladder muscle is a histological feature characteristic of noncompliant bladder 5,7. In animal studies, bladder wall compliance is closely related to the collagen and elastin content 8,9. In addition, insulin-like growth factor-1 (IGF-1) and transforming growth factor-beta 1 (TGF-β1) were reported to be involved in tissue remodelling and bladder wall fibrosis after SCI 9-11. Patients with chronic SCI and neurogenic bladder symptoms are currently treated with antimuscarinic medications, β3-adrenoceptor agonists, and bladder catheterization. However, these therapeutic methods are not effective and associated with adverse effects, such as dry mouth and constipation 12. Recent research efforts have focused on attempts to regenerate the injured spinal cord using cell transplantation 13. A previous study showed that the treatment of SCI with umbilical cord blood stem cells could...