Tissue engineering and cell therapies for neurogenic bladder augmentation and urinary continence restoration

2015 ◽  
pp. 571-582
Author(s):  
René Yiou
Keyword(s):  
Tissue Engineering ◽  
Neurogenic Bladder ◽  
Bladder Augmentation ◽  
Urinary Continence ◽  
Cell Therapies

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.

657 BLADDER AUGMENTATION BY TISSUE ENGINEERING USING MULTIPLE SCAFFOLDS IN ONE BLADDER AND GROWTH FACTORS IN A PORCINE MODEL

2011 ◽  
Vol 10 (2) ◽  
pp. 212
Author(s):  
L.A.J. Roelofs ◽  
B.B.M. Kortmann ◽  
Gier R.P.E. De ◽  
F. Farag ◽  
T.M. Tiemessen ◽  
...  
Keyword(s):  
Tissue Engineering ◽  
Growth Factors ◽  
Porcine Model ◽  
Bladder Augmentation

Long-Term Urodynamics Followup of Bladder Augmentation for Neurogenic Bladder

2003 ◽  
Vol 169 (1) ◽  
pp. 195-198 ◽  
Author(s):  
MARCUS L. QUEK ◽  
DAVID A. GINSBERG
Keyword(s):  
Neurogenic Bladder ◽  
Bladder Augmentation

scholarly journals Decision Support Tools for Regenerative Medicine: Systematic Review (Preprint)

2018 ◽  
Author(s):  
Ching Lam ◽  
Edward Meinert ◽  
Abrar Alturkistani ◽  
Alison R. Carter ◽  
Jeffrey Karp ◽  
...  
Keyword(s):  
Tissue Engineering ◽  
Gene Therapy ◽  
Decision Support ◽  
Regenerative Medicine ◽  
Product Development ◽  
Cost Effective ◽  
Decision Support Tools ◽  
Cell Therapies ◽  
Allogeneic Cell Therapy ◽  
Support Tools

BACKGROUND Decisional tools have demonstrated their importance in informing manufacturing and commercial decisions in the monoclonal antibody domain. Recent approved therapies in regenerative medicine have shown great clinical benefits to patients. OBJECTIVE The objective of this review was to investigate what decisional tools are available and what issues and gaps have been raised for their use in regenerative medicine. METHODS We systematically searched MEDLINE to identify articles on decision support tools relevant to tissue engineering, and cell and gene therapy, with the aim of identifying gaps for future decisional tool development. We included published studies in English including a description of decisional tools in regenerative medicines. We extracted data using a predesigned Excel table and assessed the data both quantitatively and qualitatively. RESULTS We identified 9 articles addressing key decisions in manufacturing and product development challenges in cell therapies. The decision objectives, parameters, assumptions, and solution methods were analyzed in detail. We found that all decisional tools focused on cell therapies, and 6 of the 9 reviews focused on allogeneic cell therapy products. We identified no available tools on tissue-engineering and gene therapy products. These studies addressed key decisions in manufacturing and product development challenges in cell therapies, such as choice of technology, through modeling. CONCLUSIONS Our review identified a limited number of decisional tools. While the monoclonal antibodies and biologics decisional tool domain has been well developed and has shown great importance in driving more cost-effective manufacturing processes and better investment decisions, there is a lot to be learned in the regenerative medicine domain. There is ample space for expansion, especially with regard to autologous cell therapies, tissue engineering, and gene therapies. To consider the problem more comprehensively, the full needle-to-needle process should be modeled and evaluated.

Tissue engineering

2013 ◽  
pp. 664-668
Author(s):  
Andrew McCaskie ◽  
Paul Genever ◽  
Cosimo De Bari
Keyword(s):  
Tissue Engineering ◽  
Host Tissue ◽  
Target Tissue ◽  
Cell Therapies ◽  
Cell Matrix ◽  
Wide Range ◽  
Regenerative Approach ◽  
Great Relevance ◽  
Functional Interface

The field of tissue engineering has developed rapidly over the last few decades and is of great relevance to musculoskeletal therapy and intervention. Tissue engineering strategies are often considered in a simplified form in terms of cells, scaffolds, and additional factors, although it should be noted that successful translation of such a strategy is more complex. There are many variations of usage and combination and it is not necessary for all three to be provided by the proposed treatment. However, the regenerative approach must produce both the quantity and quality of target tissue at the level of the cell, matrix, and environment. Moreover, the regenerated tissue must interact with the host tissue with a seamless biological and functional interface. Tissue engineering, regenerative medicine, and cell therapies have developed significantly over the last few decades and are applicable to a wide range of musculoskeletal applications. Many strategies have been identified that would potentially benefit patients but the future will require successful translation from the laboratory into clinical practice. It is important to identify clinical targets where there is both clinical need and an informed view that the approach is likely to be successful.

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