China
Africa
Explore chapters and articles related to this topic
Mechanical Signaling in the Urinary Bladder
Published in Jiro Nagatomi, Eno Essien Ebong, Mechanobiology Handbook, 2018
Aruna Ramachandran, Ramaswamy Krishnan, Rosalyn M. Adam
Medical therapy is a mainstay of treatment for lower urinary tract dysfunction. However, in certain patients, surgical intervention in the form of bladder augmentation is necessary to restore bladder function. The standard approach involves the use of intestinal segments to increase bladder capacity, but is often hampered by serious complications related to the absorptive nature of the donor tissue. As a result, much effort has been expended in the search for appropriate substitutes, ranging from synthetic scaffolds to autologous neobladders with many of these efforts leading to the creation of a new field of functional tissue engineering (reviewed in [126]). It has become apparent in recent years that conditioning of engineered tissues with appropriate mechanical stimulation prior to implantation is likely to be critical for successful regeneration of functional tissues in vivo [127–129]. Mechanical stimuli, in the form of cyclical filling and emptying, are an important component of normal bladder development [130]. Indeed, the absence of the physical forces conferred by bladder cycling in utero is believed to contribute to the devastating failure of bladder development, as observed in classic exstrophy [130]. Understanding how to recapitulate appropriate mechanical signals during the process of engineering replacement tissues and how to integrate them with innervation and vasculogenesis will represent a significant breakthrough in functional tissue regeneration. This topic has been summarized in two excellent recent reviews [128,129] and is not considered further here.
Bladder Tissue Engineering
Published in Gilson Khang, Handbook of Intelligent Scaffolds for Tissue Engineering and Regenerative Medicine, 2017
Bladder reconstruction, augmentation and complete replacement is indicated for a variety of clinical indications, ranging from bladder cancer, trauma, congenital defect (bladder exstrophy), neuropathic bladder, small-volume bladders, or inflammation.5 Current state-of-the-art methods rely on surgical techniques where autologous gastrointestinal tissues are harvested to augment bladders or create neobladders. The incompatibility of the gastrointestinal tissue (mostly ileum) with the bladder environment can lead to complications such as metabolic disorders, bladder perforation, stone formation, infections, hematuria-dysuria syndrome, and potential development of cancer due to metaplasia.6 The ideal outcome of bladder augmentation is a continent compliant bladder with self-control.7
Constructing artificial urinary conduits: current capabilities and future potential
Published in Expert Review of Medical Devices, 2019
Jan Adamowicz, Shane V. Van Breda, Tomasz Kloskowski, Kajetan Juszczak, Marta Pokrywczynska, Tomasz Drewa
Autologous urothelial cells derived from bladder biopsies were used in the study of Geutjes et al. [21]. They performed urinary tract diversions with a urinary conduit on a porcine model. Urothelial cells were seeded on the inner side of a tubular scaffold to imitate the typical histology of the urinary tract wall. Remarkably there were no differences observed between cellular and acellular groups. Epithelial outgrowth and smooth muscle bundle elongation were mainly present at the end of the construct with the ureteral anastomosis; implicating that the role of pre-seeded urothelial cells in the acceleration of conduit lumen epithelization might be overestimated. The above assumption is consistent with our experience from bladder augmentation with different biomaterial patches [22].