Transplantation of preserved human amniotic membrane for bladder augmentation and urethral sub-mucosal injection

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Gastrointestinal segments have been widely used for bladder augmentation. However, they are not ideal because of the possible complications. Firstly, we performed bladder augmentation in rats using human amniotic membrane (hAM). Morphologically, the hAM-augmented bladder exhibited regeneration of urothelium, detrusor smooth muscle, and nerve fibers within 3 months post-operatively.By functional evaluation of the bladder strips, we compared hAM-augmented bladders with bladders augmented by small intestinal submucosa (SIS). Both hAM- and SIS-augmented bladders displayed adequate capacity and compliance. The results indicate that, for bladder augmentation, hAM can be used as a scaffold and is comparable in this respect with SIS.Secondly, we confirmed that crashed and cultured amniotic cells injected under bladder mucosa exhibited differentiation into smooth muscle cells using immunohistochemical studies.Human amniotic membrane can be more easily obtained than other materials and requires little preparation, and its use raises few ethical questions. Therefore, hAM may represent a new therapeutic alternative for urological reconstructions.