27 - Techniques for engineering bladder tissue

Abstract

Congenital disorders, cancer, trauma, infection, inflammation, iatrogenic injuries, or other conditions of the bladder can lead to organ damage or complete loss of function. Most of these situations require eventual reconstructive procedures. These procedures can be performed with native non-urological tissues (skin, gastrointestinal segments, or mucosa), homologous tissues from a donor (cadaver or living donor kidney), heterologous tissues or substances (bovine collagen), or artificial materials (silicone, polyurethane, Teflon). However, these materials often lead to complications after reconstruction. The implanted tissue is sometimes rejected, and often the inherently different functional aspects of the different tissues or materials used in the reconstruction cause a mismatch in the system. As an example, current methods of replacing bladder tissue with gastrointestinal segments can be problematic due to the opposite ways in which these two tissues handle solutes – urological tissue normally excretes material, but gastrointestinal tissue generally absorbs the same materials, and such a mismatch can lead to metabolic complications as well as infection. The replacement of lost or deficient urological tissues with functionally equivalent ones would improve the outcome of reconstructive surgery for the bladder. This may soon be possible with novel tissue engineering techniques.