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The bladder is a dynamic organ, performing complex physiological functions essential to its role as a biological reservoir to efficiently store and release urine as needed. Although simple in structure—a hollow organ—the bladder is essential for survival and maintaining a satisfactory quality of life. However, pathological conditions frequently lead to irreversible damage, impairing the bladder's normal function and requiring surgical reconstruction. Traditionally, non-urinary autologous grafts, mainly sourced from the gastrointestinal tract, have been the gold standard for augmenting or replacing diseased bladder tissue. However, this approach often results in various clinical complications that severely impact quality of life and require extensive lifelong followup care. A biocompatible material-based bladder augments implant presents a promising alternative with the potential to revolutionize the current treatment standards. Thus, our goal is to develop an acellular alloplastic bladder augment constructed from titanium to enhance functional capacity and eliminate the need for major bowel surgery. This work aims to improve and modernize current bladder augmentation procedures by introducing the use of thin medical-grade titanium sheets as implants within a bivalved bladder. The proposed bladder augmentation has the potential to change the field of urological surgery and overcome challenges that prior efforts have faced, such as the interface between native tissue and biocompatible materials and encrustation. Developing the proposed procedure with a titanium implant would drastically improve functional urological reconstruction procedures. Patients will benefit from a less invasive procedure, shorter hospitalization, and greater therapeutic success. Furthermore, this innovative procedure will expand treatment options to patients ineligible for bowel-based augmentation procedures due to comorbidities, such as inflammatory bowel disease or prior radiation. The proposed work aims to develop and refine surgical techniques for successfully implanting titanium augments into a bivalved bladder in pigs. Following the establishment of these techniques, long-term studies will be conducted on the implanted titanium in pigs. Histopathological analysis will assess potential tissue complications related to the titanium augment, while analytical chemistry methods will evaluate and quantify encrustation on the titanium surface. The success of this project could lead to significant advancements in acellular synthetic organ augmentation and repair, with broad implications for urology and other medical fields.
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