Advances in preclinical tissue engineering strategies for bladder reconstruction: a systematic review.
AI interpretation is pending for this paper.
Open original publication →What the AI sees
Not AI summarized yet.
Research significance
Pending deeper interpretation.
Source abstract
INTRODUCTION: Bladder reconstruction remains challenging in pediatric patients needing augmentation cystoplasty for congenital anomalies, malignancies, or trauma. This review synthesizes in vitro and in vivo evidence on tissue-engineering strategies for pediatric bladder reconstruction. MATERIALS AND METHODS: PRISMA guidelines were followed. PubMed, Scopus, and Embase were searched from inception to May 2025. Eligible studies investigated bioengineered constructs for pediatric bladder reconstruction and reported histological, molecular, or functional outcomes. Two reviewers independently performed study selection and data extraction, resolving disagreements by consensus. RESULTS: Seventy-three studies met inclusion criteria. Natural polymeric scaffolds predominated (61.6%), followed by synthetic (20.5%) and hybrid scaffolds (17.8%). Functionalization included VEGF, IGF-1, bFGF, surface patterning, and nanoparticles. Among cell-seeded studies (n=44), mesenchymal stem cells predominated, followed by urothelial cells, smooth muscle cells, and co-cultures. Among 54 in vivo studies, models included rodents (n=30), rabbits (n=10), pigs (n=9), dogs (n=4), baboons (n=1), chicken embryos (n=1). Categories overlapped, as one study included both rats and pigs. Urothelial and smooth muscle regeneration was reported in all in vivo studies, angiogenesis in 90.7%. Functional bladder capacity was assessed in 34 studies, mainly in acellular scaffolds. Natural scaffolds supported regeneration, whereas synthetic scaffolds often required natural components; hybrid scaffolds showed variable integration. Immune responses were mild with natural ECM-based scaffolds, moderate with hybrids, and prolonged with synthetics. Thirty studies reported complications. CONCLUSION: Durable functional regeneration appears dependent on integrated scaffold designs combining mechanical support, ECM-derived bioactivity, and biological cues. Composite and biofunctionalized scaffolds yielded consistent results, but large-animal studies remain essential for clinical translation.