Skip to main content

Advertisement

SpringerLink
Log in

Functional improvement in spinal cord injury-induced neurogenic bladder by bladder augmentation using bladder acellular matrix graft in the rat

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Kruse MN, Belton AL, de Groat WC (1993) Changes in bladder and external urethral sphincter function after spinal cord injury in the rat. Am J Physiol 264:R1157–1163

    PubMed  CAS  Google Scholar 

  2. Shaker H, Mourad MS, Elbialy MH, Elhilali M (2003) Urinary bladder hyperreflexia: a rat animal model. Neurourol Urodyn 22:693–698

    Article  PubMed  Google Scholar 

  3. Kashif KM, Holmes SA (1998) The use of small intestine in bladder reconstruction. Int Urogynecol J Pelvic Floor Dysfunct 9:275–280

    Article  PubMed  CAS  Google Scholar 

  4. Shekarriz B, Upadhyay J, Demirbilek S, Barthold JS, Gonzalez R (2000) Surgical complications of bladder augmentation: comparison between various enterocystoplasties in 133 patients. Urology 55:123–128

    Article  PubMed  CAS  Google Scholar 

  5. Piechota HJ, Dahms SE, Nunes LS, Dahiya R, Lue TF, Tanagho EA (1998) In vitro functional properties of the rat bladder regenerated by the bladder acellular matrix graft. J Urol 159:1717–1724

    Article  PubMed  CAS  Google Scholar 

  6. Piechota HJ, Dahms SE, Probst M, Gleason CA, Nunes LS, Dahiya R, Lue TF, Tanagho EA (1998) Functional rat bladder regeneration through xenotransplantation of the bladder acellular matrix graft. Br J Urol 81:548–559

    PubMed  CAS  Google Scholar 

  7. Piechota HJ, Gleason CA, Dahms SE, Dahiya R, Nunes LS, Lue TF, Tanagho EA (1999) Bladder acellular matrix graft: in vivo functional properties of the regenerated rat bladder. Urol Res 27:206–213

    Article  PubMed  CAS  Google Scholar 

  8. Wefer J, Sievert KD, Schlote N, Wefer AE, Nunes L, Dahiya R, Gleason CA, Tanagho EA (2001) Time dependent smooth muscle regeneration and maturation in a bladder acellular matrix graft: histological studies and in vivo functional evaluation. J Urol 165:1755–1759

    Article  PubMed  CAS  Google Scholar 

  9. Dahms SE, Piechota HJ, Dahiya R, Gleason CA, Hohenfellner M, Tanagho EA (1998) Bladder acellular matrix graft in rats: its neurophysiologic properties and mRNA expression of growth factors TGF-alpha and TGF-beta. Neurourol Urodyn 17:37–54

    Article  PubMed  CAS  Google Scholar 

  10. Youssif M, Shiina H, Urakami S, Gleason C, Nunes L, Igawa M, Enokida H, Tanagho EA, Dahiya R (2005) Effect of vascular endothelial growth factor on regeneration of bladder acellular matrix graft: histologic and functional evaluation. Urology 66:201–207

    Article  PubMed  Google Scholar 

  11. Blaivas JG (1982) The neurophysiology of micturition: a clinical study of 550 patients. J Urol 127:958–963

    PubMed  CAS  Google Scholar 

  12. Pesce F, Castellano V, Finazzi Agro E, Giannantoni A, Tamburro F, Vespasiani G (1997) Voiding dysfunction in patients with spinal cord lesions at the thoracolumbar vertebral junction. Spinal Cord 35:37–39

    Article  PubMed  CAS  Google Scholar 

  13. Light JK, Faganel J, Beric A (1985) Detrusor areflexia in suprasacral spinal cord injuries. J Urol 134:295–297

    PubMed  CAS  Google Scholar 

  14. Cayan S, Chermansky C, Schlote N, Sekido N, Nunes L, Dahiya R, Tanagho EA (2002) The bladder acellular matrix graft in a rat chemical cystitis model: functional and histologic evaluation. J Urol 168:798–804

    Article  PubMed  Google Scholar 

  15. de Groat WC, Kawatani M, Hisamitsu T, Cheng CL, Ma CP, Thor K, Steers W, Roppolo JR (1990) Mechanisms underlying the recovery of urinary bladder function following spinal cord injury. J Auton Nerv Syst 30 Suppl:S71–77

    PubMed  Google Scholar 

  16. Barton CH, Khonsari F, Vaziri ND, Byrne C, Gordon S, Friis R (1986) The effect of modified transurethral sphincterotomy on autonomic dysreflexia. J Urol 135:83–85

    PubMed  CAS  Google Scholar 

  17. de Seze M, Wiart L, de Seze MP, Soyeur L, Dosque JP, Blajezewski S, Moore N, Brochet B, Mazaux JM, Barat M, Joseph PA (2004) Intravesical capsaicin versus resiniferatoxin for the treatment of detrusor hyperreflexia in spinal cord injured patients: a double-blind, randomized, controlled study. J Urol 171:251–255

    Article  PubMed  Google Scholar 

  18. Khullar V, Chapple C, Gabriel Z, Dooley JA (2006) The effects of antimuscarinics on health-related quality of life in overactive bladder: a systematic review and meta-analysis. Urology 68:38–48

    Article  PubMed  Google Scholar 

  19. Finney SM, Andersson KE, Gillespie JI, Stewart LH (2006) Antimuscarinic drugs in detrusor overactivity and the overactive bladder syndrome: motor or sensory actions? BJU Int 98:503–507

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Support: Department of Defense (DOD), VA Merit Review and Deutsche, Forschungsgemeinschaft FA 479/1-1.

Author information

Authors and Affiliations

  1. Department of Urology, Veterans Affairs Medical Center, University of California, 4150 Clement Street, San Francisco, CA, 94121, USA

    Shinji Urakami, Hiroaki Shiina, Hideki Enokida, Ken Kawamoto, Nobuyuki Kikuno, Thomas Fandel, Kaveh Vejdani, Lora Nunes, Emil A. Tanagho & Rajvir Dahiya

  2. Department of Urology, Faculty of Medicine, Shimane University, Izumo, 693-8501, Japan

    Shinji Urakami, Hiroaki Shiina, Nobuyuki Kikuno & Mikio Igawa

  3. Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, 890-8520, Japan

    Hideki Enokida & Ken Kawamoto

Authors
  1. Shinji Urakami
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroaki Shiina
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hideki Enokida
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ken Kawamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nobuyuki Kikuno
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Thomas Fandel
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kaveh Vejdani
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Lora Nunes
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mikio Igawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Emil A. Tanagho
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Rajvir Dahiya
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rajvir Dahiya.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Urakami, S., Shiina, H., Enokida, H. et al. Functional improvement in spinal cord injury-induced neurogenic bladder by bladder augmentation using bladder acellular matrix graft in the rat. World J Urol 25, 207–213 (2007). https://doi.org/10.1007/s00345-006-0142-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-006-0142-7

Keywords

Search

Navigation