Patients with bladder disease can have problems with high pressures within their bladders that may lead to kidney damage. The condition can be treated with bladder reconstructive surgery. The procedure, which usually involves tissue grafts from a section of the small intestine or stomach, can protect kidney function and improve incontinence in patients. However, the use of such tissue segments has been associated with many complications.
Anthony Atala (Wake Forest University Medical School, Winston-Salem, NC, USA) and colleagues investigated an alternative approach using engineered bladders grown from patients' own cells. They identified seven patients, aged 4-19 years, who had poor bladder function due to a myelomeningocele (a congenital anomaly). The team obtained a bladder biopsy from each patient, from which they grew muscle cells and special bladder cells (urothelial cells) in the lab. The cells were then placed onto a specially designed bladder-shaped scaffold and left to grow for seven to eight weeks. The researchers surgically attached the engineered bladder to the patient's own bladder and followed progress for 2-5 years. They found that bladder function improved without any of the ill effects associated with the technique using bowel tissue.
Dr Atala states: "The implanted composite engineered bladders showed improved functional parameters that were durable over a period of years. Although follow-up longer than 5 years is reported, additional studies will be needed before this procedure can be used widely."