Regenerative medicine strategies for treatment of neurogenic bladder.

Neurogenic bladder is a general term encompassing various neurologic dysfunctions in the bladder and external urethral sphincter caused by damage or disease. Therapeutic management options fall into the categories of conservative, minimally invasive or surgical. The current standard for surgical management is bladder augmentation using intestinal segments. However, because intestinal tissue possesses different functional characteristics to bladder tissue, numerous complications can ensue. Regenerative medicine uses combinations of cells and/or biomaterials to encourage regeneration of healthy tissue and offers an alternative approach for the replacement of lost or deficient organs, including the bladder. Promising results using the principles of regenerative medicine have already been obtained in children with neurogenic bladder caused by myelomeningocele. Human clinical trials, governed by the US FDA, are ongoing in the USA in both children and adults to further evaluate the safety and efficacy of this technology for regenerating bladders. More studies are in progress and additional advances in this field can be anticipated.