SUMMARY
Each year in the United States, trauma, radiation therapy to treat urological cancers, severe cases of spina
bifida, and interstitial cystitis contribute to at least 14,000 bladder augmentation enterocystoplasty surgeries.
Although it is the standard of care for patients with an end-stage pathologic bladder, enterocystoplasty causes
many complications due to anatomical and physiological differences between bladder tissue and the bowel
tissue used to augment the bladder’s capacity. Several strategies have been reported to replace
enterocystoplasty and regenerate bladder tissue but these have failed clinically. Reasons for the failure include
the common use of phylogenetically dissimilar pre-clinical animal models that do not accurately represent the
human bladder or its disease condition, the use of inadequate materials to serve as scaffolds for cells to grow
on and regenerate bladder tissue, the use of often diseased autologous bladder cells that have lost the
capacity to regenerate functional bladder tissue, and an inability to continuously monitor the tissue
regeneration process to identify potential problems at an early stage. As a result, there is currently no viable
alternative to augmentation enterocystoplasty. Regenerative engineering is a convergence of advanced
material science, stem cell science, physics, and clinical translation. The overall goal of this project is to drive
the development of unprecedented regenerative engineering tools and technologies via the integration of stem
cell science, advanced biomaterials, and bio-integrated electronics to enable the regeneration of functional
bladder tissue and the non-invasive, real-time assessment thereof to better predict outcome. Toward this goal,
we have demonstrated our ability to: a) regenerate vascularized and innervated bladder tissue in a rat bladder
augmentation model using a combination of bone marrow (BM) mesenchymal stem cells (MSCs),
hematopoietic stem/progenitor cells (HSPCs), and an antioxidant citrate-based biodegradable elastomer, b)
demonstrated successful bladder reconstruction with autologous cell-seeded POC scaffolds at 6 months in
baboon;
c) measure rat bladder pressure and control its function via a bio-integrated electronic strain gauge
and light-activated excitatory channels, d) integrate stretchable electronics into citrate-based elastomers, and
e) achieve wireless transmission of real time physiological data obtained in vivo using bio-integrated
electronics. Towards our goal, the specific aims of this proposal are to: 1) Design, fabricate, and characterize
bio-integrated electronics that monitor and modulate the function of regenerating bladder tissue via telemetry,
2) Engineer and characterize Stretch Monitoring Advanced Regenerative Telemetric (SMART) scaffolds for
bladder augmentation, and 3) Assess the safety and efficacy of bladder conformal stretchable electronics and
SMART scaffolds in a baboon bladder augmentation model.