Regenerative medicine and the neurogenic bladder

Control of normal bladder function by the nervous system has been described in great detail. In some cases of injury to the spinal cord, neurogenic bladder dysfunction develops, typified by detrusor sphincter dyssynergia and decreasing bladder capacity and compliance. Numerous therapies, including anticholinergic agents, botulinum toxin, neuromodulation, and clean intermittent catheterization, have been used to maintain physiologic pressures in the neurogenic bladder. When bladder compliance falls to a dangerous level despite these treatments, enterocystoplasty has been the gold-standard therapy. Although this procedure increases bladder capacity and compliance, it has been plagued by complications, such as metabolic disorders, perforations, excessive mucous productions, and stones. Recently, the field of regenerative medicine has offered novel and improved therapies for this chronic condition. This review summarizes these recent advances.