title: Functional improvement in spinal cord injury-induced neurogenic bladder by bladder augmentation using bladder acellular matrix graft in the rat.
abstract: Spinal cord injury (SCI) rostral to the lumbosacral level causes bladder hyperreflexia and detrusor-sphincter dyssynergia (DSD), which are accompanied by bladder hypertrophy. We hypothesize that bladder augmentation using a bladder acellular matrix graft (BAMG) can improve the function of SCI-mediated neurogenic bladder. In female rats (n = 35), SCI was induced by transection of the spinal cord at the lower thoracic level. Eight weeks following spinalization, bladder augmentation using BAMG was performed after hemicystectomy of the hypertrophic bladder. Cystometrography was performed at 8 weeks after spinalization and again at 8 weeks after augmentation. Several urodynamic parameters were measured and the grafted bladder was histologically evaluated. Thirty one rats were alive 8 weeks after spinalization. Twenty two (71%) rats developed hyperreflexic bladders and nine (29%) rats had underactive bladders before bladder augmentation. Twenty six rats survived until 8 weeks after augmentation. Urodynamic parameters showed improvement in some bladder functions in both hyperreflexic and underactive bladders after augmentation. In addition, bladder compliance was increased in hyperreflexic bladders and decreased in underactive bladders. Bladder augmentation decreased bladder capacity in high-capacity rats and increased it in low-capacity rats. Histological evaluation showed complete regeneration of BAMG in SCI-induced neurogenic bladder at 8 weeks after augmentation. This is the first report suggesting that the voiding function in SCI-induced neurogenic bladder can be improved by augmentation using BAMG. Improved voiding function was accompanied by histological regeneration of BAMG.
authors.affiliation: Department of Urology, Veterans Affairs Medical Center, University of California, 4150 Clement Street, San Francisco, CA 94121, USA.
authors.forename: Shinji
authors.initials: S
authors.lastname: Urakami
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shiina
authors.forename: Hideki
authors.initials: H
authors.lastname: Enokida
authors.forename: Ken
authors.initials: K
authors.lastname: Kawamoto
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kikuno
authors.forename: Thomas
authors.initials: T
authors.lastname: Fandel
authors.forename: Kaveh
authors.initials: K
authors.lastname: Vejdani
authors.forename: Lora
authors.initials: L
authors.lastname: Nunes
authors.forename: Mikio
authors.initials: M
authors.lastname: Igawa
authors.forename: Emil A
authors.initials: EA
authors.lastname: Tanagho
authors.forename: Rajvir
authors.initials: R
authors.lastname: Dahiya
mesh_terms: D000818:Animals; D005109:Extracellular Matrix / Q000637:transplantation*; D005260:Female; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D020127:Recovery of Function / Q000502:physiology*; D013119:Spinal Cord Injuries / Q000150:complications*; D013904:Thoracic Vertebrae; D023822:Tissue Engineering; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery*; D014554:Urination / Q000502:physiology; D014563:Urodynamics / Q000502:physiology