Urinary bladder regenerative medicine

One of the greatest challenges in urology is the surgical replacement of urinary bladder tissue. In a variety of pathological conditions, the bladder must be replaced or its capacity expanded in order to store urine at a low pressure, avoiding potential damage to the kidneys. The gold standard in current practice involves the incorporation of a vascularized patch of detubularized bowel into the urinary bladder, leading to a wide variety of complications with the potential loss of the ability to empty urine in a volitional manner. In an effort to circumvent these issues, multiple investigators have utilized different scaffolding materials in hopes of avoiding the continued reliance on intestinal tissue in bladder replacement surgery. The optimal biomaterial would be able to reproduce the function, elasticity, vascularity, and innervation of the native bladder tissue so as to recreate normal voiding, ideally combined with multipotent stem/progenitor cells. Although the histological and physiological function of the urinary system is complex, decades of research into bladder tissue engineering has lead to significant progress in the quest for the ideal biomaterial.