Small-intestinal submucosa for bladder augmentation: a review of preclinical studies

The need to find an alternative to the use of bowel for urinary reconstruction has renewed research interests involving bladder regeneration. Historically, alloplastic and biodegradable materials have demonstrated bladder regeneration; however, high complication rates and unreliable regenerative results have prevented any of these materials from being used clinically. Small-intestinal submucosa (SIS) is an acellular, nonimmunogenic, biodegradable, xenogeneic, collagen-based material that is derived from the submucosa layer of porcine small intestine. SIS has demonstrated regenerative capacities in multiple organ systems, including the aorta, vena cava, ligaments, tendons, abdominal wall, and skin. SIS has also demonstrated long-term reliable regenerative results in the rat and canine bladder-augmentation models. This article reviews the preclinical studies involving the use of SIS for bladder augmentation.