scholarly journals Non-Traditional Management of the Neurogenic Bladder: Tissue Engineering and Neuromodulation

2007 ◽  
Vol 7 ◽  
pp. 1230-1241 ◽  
Author(s):  
Jane M. Lewis ◽  
Earl Y. Cheng
Keyword(s):  
Tissue Engineering ◽  
Spina Bifida ◽  
Neurogenic Bladder ◽  
Cell Biology ◽  
Bladder Wall ◽  
Bladder Augmentation ◽  
Current Status ◽  
Urinary Continence ◽  
Clean Intermittent Catheterization ◽  
Bladder Tissue

Patients with spina bifida and a neurogenic bladder have traditionally been managed with clean intermittent catheterization and pharmacotherapy in order to treat abnormal bladder wall dynamics, protect the upper urinary tract from damage, and achieve urinary continence. However, some patients will fail this therapy and require surgical reconstruction in the form of bladder augmentation surgery using reconfigured intestine or stomach to increase the bladder capacity while reducing the internal storage pressure. Despite functional success of bladder augmentation in achieving a low pressure reservoir, there are several associated complications of this operation and patients do not have the ability to volitionally void. For these reasons, alternative treatments have been sought. Two exciting alternative approaches that are currently being investigated are tissue engineering and neuromodulation. Tissue engineering aims to create new bladder tissue for replacement purposes with both “seeded” and “unseeded” technology. Advances in the fields of nanotechnology and stem cell biology have further enhanced these tissue engineering technologies. Neuromodulation therapies directly address the root of the problem in patients with spina bifida and a neurogenic bladder, namely the abnormal relationship between the nerves and the bladder wall. These therapies include transurethral bladder electrostimulation, sacral neuromodulation, and neurosurgical techniques such as selective sacral rhizotomy and artificial somatic-autonomic reflex pathway construction. This review will discuss both tissue engineering techniques and neuromodulation therapies in more detail including rationale, experimental data, current status of clinical application, and future direction.

scholarly journals Ten years’ experience of augmentation cystoplasty for varied indications and its outcome

2020 ◽  
Vol 7 (4) ◽  
pp. 1031
Author(s):  
Hemangi R. Athawale ◽  
Shivaji B. Mane ◽  
Natasha Vagheriya ◽  
Prathamesh More ◽  
Taha Daginawala
Keyword(s):  
Serum Creatinine ◽  
Neurogenic Bladder ◽  
Surgical Techniques ◽  
Bladder Augmentation ◽  
Renal Outcome ◽  
Urinary Continence ◽  
Ectopic Ureter ◽  
Safe Procedure ◽  
Augmentation Cystoplasty

Background: The aim of the study was to evaluate long term efficacy and complications of augmentation cystoplasty in patients with bladder dysfunction.  Methods: Our series comprises of 30 patients undergoing enterocystoplasty from March 2009 till December 2019. Clinical findings and investigations result along with surgical techniques used were noted for these patients. Postoperative complications along with urinary continence and renal outcome were evaluated.Results: Mean age of patients was 7 years and their mean follow up was for 4 years. Major complications occurred in 5 patients which were successfully managed and minor complication in 8 patients. Of these 16 patients were with neurogenic bladder and 14 with non-neurogenic bladder. The primary etiology of non-neurogenic bladder was extrophy epispadias complex (10 patients), posterior uretheral valves (2 patients), anterior uretheral valve (1 patient), and bilateral ectopic ureter (1 patient). The primary etiology of neurogenic bladder was meningomyocele (4 patients), anorectal malformation with vertebral anomalies (7 patients), partial sacral ageneis (4), nonneurogenic neurogenic bladder (1 patient). Relative continence was achieved in 97%. The preoperative serum creatinine and blood urea nitrogen (BUN) at the time of bladder augmentation (termed  creatinine-1 and BUN-1)and the serum  creatinine and BUN at the last follow up after bladder augmentation (termed  creatinine-2 and BUN-2)were sought and compared using chi square test showed statistically significant improvement (p<0.01).Conclusions: Augmentation cystoplasty is a necessary and safe procedure to increase the functional capacity of small contracted and poorly compliant bladder and allows patients to achieve relative continence and preserves renal function.

scholarly journals Medical Management of Neurogenic Bladder for Children and Adults: A Review

2019 ◽  
Vol 25 (3) ◽  
pp. 195-204
Author(s):  
Elizabeth Lucas
Keyword(s):  
Quality Of Life ◽  
Neurogenic Bladder ◽  
Medical Management ◽  
Chronic Condition ◽  
Upper Urinary Tract ◽  
Urinary Continence ◽  
Clean Intermittent Catheterization ◽  
Successful Management ◽  
Bladder Drainage

Neurogenic bladder is a chronic condition affecting patients of all ages with significant medical and quality of life implications. Goals of treatment consist of protection of the upper urinary tract and promotion of reliable urinary continence. Successful management involves medications and most often bladder drainage via clean intermittent catheterization. This article reviews current literature on medical management to achieve goals of treatment.

scholarly journals Trends in Tissue Engineering for Blood Vessels

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Judee Grace Nemeno-Guanzon ◽  
Soojung Lee ◽  
Johan Robert Berg ◽  
Yong Hwa Jo ◽  
Jee Eun Yeo ◽  
...  
Keyword(s):  
Tissue Engineering ◽  
Blood Vessel ◽  
Blood Vessels ◽  
Human Health ◽  
Cell Biology ◽  
Cardiovascular Health ◽  
Current Status ◽  
Cardiovascular Tissue ◽  
Historical View ◽  
Tissue Reconstruction

Over the years, cardiovascular diseases continue to increase and affect not only human health but also the economic stability worldwide. The advancement in tissue engineering is contributing a lot in dealing with this immediate need of alleviating human health. Blood vessel diseases are considered as major cardiovascular health problems. Although blood vessel transplantation is the most convenient treatment, it has been delimited due to scarcity of donors and the patient’s conditions. However, tissue-engineered blood vessels are promising alternatives as mode of treatment for blood vessel defects. The purpose of this paper is to show the importance of the advancement on biofabrication technology for treatment of soft tissue defects particularly for vascular tissues. This will also provide an overview and update on the current status of tissue reconstruction especially from autologous stem cells, scaffolds, and scaffold-free cellular transplantable constructs. The discussion of this paper will be focused on the historical view of cardiovascular tissue engineering and stem cell biology. The representative studies featured in this paper are limited within the last decade in order to trace the trend and evolution of techniques for blood vessel tissue engineering.

scholarly journals Spontaneous Bladder Perforation in an Infant Neurogenic Bladder: Laparoscopic Management

2013 ◽  
Vol 2013 ◽  
pp. 1-2
Author(s):  
Daniel Cabezalí Barbancho ◽  
Felix Guerrero Ramos ◽  
Francisco López Vázquez ◽  
Adolfo Aransay Bramtot ◽  
Andrés Gómez Fraile
Keyword(s):  
Acute Abdomen ◽  
Neurogenic Bladder ◽  
Signs And Symptoms ◽  
Bladder Augmentation ◽  
Bladder Perforation ◽  
Bladder Rupture ◽  
Free Fluid ◽  
Clean Intermittent Catheterization ◽  
Voiding Function ◽  
Spontaneous Bladder Rupture

Spontaneous bladder perforation is an uncommon event in childhood. It is usually associated with bladder augmentation. We are presenting a case of bladder rupture in an infant with neurogenic bladder without prior bladder surgery. Three days after lipomyelomeningocele excision the patient showed signs and symptoms of acute abdomen. The ultrasound exploration revealed significant amount of intraperitoneal free fluid and therefore a laparoscopic exploration was performed. A posterior bladder rupture was diagnosed and repaired laparoscopically. Currently, being 3 years old, she keeps successfully dry with clean intermittent catheterization. Neurogenic bladder voiding function can change at any time of its evolution and lead to complications. Early diagnosis of spontaneous bladder rupture is of paramount importance, so it is essential to think about it in the differential diagnosis of acute abdomen.

scholarly journals Spheroids of Bladder Smooth Muscle Cells for Bladder Tissue Engineering

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Tim Gerwinn ◽  
Souzan Salemi ◽  
Lisa Krattiger ◽  
Daniel Eberli ◽  
Maya Horst
Keyword(s):  
Tissue Engineering ◽  
Smooth Muscle ◽  
Myogenic Differentiation ◽  
Bladder Wall ◽  
Building Blocks ◽  
Culture Conditions ◽  
Bladder Smooth Muscle ◽  
Bladder Tissue ◽  
Primary Bladder ◽  
Differentiation Marker

Cell-based tissue engineering (TE) has been proposed to improve treatment outcomes in end-stage bladder disease, but TE approaches with 2D smooth muscle cell (SMC) culture have so far been unsuccessful. Here, we report the development of primary bladder-derived 3D SMC spheroids that outperform 2D SMC cultures in differentiation, maturation, and extracellular matrix (ECM) production. Bladder SMC spheroids were compared with 2D cultures using live-dead staining, qRT-PCR, immunofluorescence, and immunoblotting to investigate culture conditions, contractile phenotype, and ECM deposition. The SMC spheroids were viable for up to 14 days and differentiated rather than proliferating. Spheroids predominantly expressed the late myogenic differentiation marker MyH11, whereas 2D SMC expressed more of the general SMC differentiation marker α-SMA and less MyH11. Furthermore, the expression of bladder wall-specific ECM proteins in SMC spheroids was markedly higher. This first establishment and analysis of primary bladder SMC spheroids are particularly promising for TE because differentiated SMCs and ECM deposition are a prerequisite to building a functional bladder wall substitute. We were able to confirm that SMC spheroids are promising building blocks for studying detrusor regeneration in detail and may provide improved function and regenerative potential, contributing to taking bladder TE a significant step forward.

scholarly journals The Significance of Biomechanics and Scaffold Structure for Bladder Tissue Engineering

2021 ◽  
Vol 22 (23) ◽  
pp. 12657
Author(s):  
Marta Hanczar ◽  
Mehran Moazen ◽  
Richard Day
Keyword(s):  
Mechanical Properties ◽  
Tissue Engineering ◽  
Bladder Wall ◽  
Bladder Capacity ◽  
Biomechanical Properties ◽  
Bladder Tissue ◽  
Long Term Effect ◽  
Target Values ◽  
Bladder Reconstruction ◽  
The Impact

Current approaches for bladder reconstruction surgery are associated with many morbidities. Tissue engineering is considered an ideal approach to create constructs capable of restoring the function of the bladder wall. However, many constructs to date have failed to create a sufficient improvement in bladder capacity due to insufficient neobladder compliance. This review evaluates the biomechanical properties of the bladder wall and how the current reconstructive materials aim to meet this need. To date, limited data from mechanical testing and tissue anisotropy make it challenging to reach a consensus on the native properties of the bladder wall. Many of the materials whose mechanical properties have been quantified do not fall within the range of mechanical properties measured for native bladder wall tissue. Many promising new materials have yet to be mechanically quantified, which makes it difficult to ascertain their likely effectiveness. The impact of scaffold structures and the long-term effect of implanting these materials on their inherent mechanical properties are areas yet to be widely investigated that could provide important insight into the likely longevity of the neobladder construct. In conclusion, there are many opportunities for further investigation into novel materials for bladder reconstruction. Currently, the field would benefit from a consensus on the target values of key mechanical parameters for bladder wall scaffolds.

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