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

胃肠道节段已广泛用于膀胱扩大术。然而，由于可能的并发症，它们并不理想。首先，我们使用人羊膜（hAM）进行大鼠膀胱扩张。术后3个月内，hAM增强的膀胱在形态学上表现出尿道、逼尿肌平滑肌和神经纤维的再生，通过膀胱条的功能评价，我们比较了hAM增强的膀胱和小肠粘膜下层（SIS）增强的膀胱。hAM和SIS增强膀胱均显示出足够的容量和顺应性。结果表明，对于膀胱扩大术，人羊膜可以用作支架，在这方面与SIS相当。第二，我们证实了破碎和培养的羊膜细胞注射膀胱粘膜下显示分化为平滑肌细胞使用免疫组化研究。人羊膜可以比其他材料更容易获得，需要很少的准备，它的使用引起了一些伦理问题。因此，hAM可能代表泌尿外科重建的新的治疗选择。

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.