Strategies of Bladder Reconstruction after Partial or Radical Cystectomy for Bladder Cancer.

ABSTRACT

The standard strategy is to reconstruct bladder by use of bowel segments as material in bladder cancer with radical cystectomy clinically. Both natural derived and non natural derived materials are investigated in bladder reconstruction. Studies on mechanical bladder, bladder transplantation and bladder xenotransplantation are currently limited although heart and kidney transplantation or xenotransplantation are successful to a certain extent, and bone prostheses are applied in clinical contexts. Earlier limited number of studies associated with bladder xenograft from animals to humans were not particular promising in results. Although there have been investigations on pig to human cardiac xenotransplantation with CRISPR Cas9 gene editing, the CRISPR Cas technique is not yet widely researched in porcine bladder related gene editing for the potential of human bladder replacement for bladder cancer. The advancement of technologies such as gene editing, bioprinting and induced pluripotent stem cells allow further research into partial or whole bladder replacement strategies. Porcine bladder is suggested as a potential source material for bladder reconstruction due to its alikeness to human bladder. Challenges that exist with all these approaches need to be overcome. This paper aims to review gene editing technology such as the CRISPR Cas systems as tools in bladder reconstruction, bladder xenotransplantation and hybrid bladder with technologies of induced pluripotent stem cells and genome editing, bioprinting for bladder replacement for bladder reconstruction and to restore normal bladder control function after cystectomy for bladder cancer.