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

胃肠道节段已被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，我们用人羊膜(HAM)对大鼠进行了膀胱扩大术。术后3个月内，HAM强化膀胱表现为尿路上皮、逼尿肌和神经纤维的再生。通过对膀胱条的功能评估，我们比较了HAM强化膀胱和小肠粘膜下层(SIS)强化膀胱。火腿和SIS增强的膀胱都显示出足够的容量和顺应性。结果表明，HAM可以作为膀胱增强的支架材料，在这方面与SIS具有可比性。其次，我们通过免疫组织化学研究证实，粉碎和培养的羊膜移植到膀胱粘膜下后，可以分化为平滑肌细胞。人羊膜比其他材料更容易获得，需要的准备很少，使用它几乎不会引起伦理问题。因此，HAM可能是一种新的泌尿重建治疗选择。

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.