Tissue engineering of diseased bladder using a collagen scaffold in a bladder exstrophy model

LAJ Roelofs, BBM Kortmann, E Oosterwijk, Alex Eggink, DM Tiemessen, AJ Crevels, Rene Wijnen, WF Daamen, TH van Kuppevelt, PJ Geutjes, WFJ Feitz

Research output: Contribution to journalArticleAcademicpeer-review

22 Citations (Scopus)


Objective To compare the regenerative capacity of diseased bladder in a large animal model of bladder exstrophy with regeneration in healthy bladder using a highly porous collagen scaffold. Materials and Methods Highly porous bovine type I collagen scaffolds with a diameter of 32 mm were prepared. In 12 fetal sheep a bladder exstrophy was surgically created at 79 days' gestation. Lambs were born at full term (140 days' gestation). After 1 week the bladder lesion was reconstructed and augmented with a collagen scaffold (group 1). In nine normal newborn lambs the bladder was augmented with a collagen scaffold 1 week after birth (group 2). Functional (video-urodynamics) and histological evaluation was performed at 1 and 6 months after surgery. Results The survival rate was 58% in group 1 and 100% in group 2. Cystograms were normal in all lambs, besides low-grade reflux in both groups. Urodynamics showed comparable capacity between both groups and a trend to lower compliance in group 1. Histological evaluation at 1 month revealed a non-confluent urothelial layer, an immature submucosa, and initial ingrowth of smooth muscle cells. At 6 months both groups showed normal urothelial lining, standard extracellular matrix development, and smooth muscle cell ingrowth. Conclusions Bladder tissue regeneration with a collagen scaffold in a diseased bladder model and in healthy bladder resulted in comparable functional and histological outcome, with a good quality of regenerated tissue involving all tissue layers. Improvements may still be needed for larger augmentations or more severely diseased bladders.
Original languageUndefined/Unknown
Pages (from-to)447-457
Number of pages11
JournalBJU International
Issue number3
Publication statusPublished - 2014

Research programs

  • EMC MGC-02-52-01-A
  • EMC MGC-02-53-01-A

Cite this