Adult stem cell therapy of female stress urinary incontinence.
OBJECTIVE
To investigate the efficacy of transurethral ultrasound (TUUS)-guided injections of autologous myoblasts and fibroblasts in women with incontinence.


METHODS
Between January and June 2005, 20 female patients suffering from stress urinary incontinence (SUI) were included. Skeletal muscle biopsies were taken from the left arm to obtain cultures from autologous fibroblasts and myoblasts. By TUUS guidance the fibroblasts were injected into the urethral submucosa and the myoblasts were injected into the rhabdosphincter. A defined incontinence score, quality-of-life score and urodynamic, electromyographic, and laboratory parameters, as well as morphology and function of urethra and rhabdosphincter were evaluated before and up to 2 yr after therapy.


RESULTS
Eighteen of 20 patients were cured 1 yr after injection of autologous stem cells and in 2 patients SUI was improved. Two years after therapy 16 of the 18 patients presented as cured, 2 others were improved, and 2 were lost to follow-up. Incontinence and quality-of-life scores were significantly improved postoperatively. The thickness of urethra and rhabdosphincter as well as activity and contractility of the rhabdosphincter were also statistically significantly increased after therapy.


CONCLUSIONS
Clinical results demonstrate that SUI can be treated effectively with autologous stem cells. The present data support the conclusion that this therapeutic concept represents an elegant and minimally invasive treatment modality to treat SUI.
Department of Urology, University of Innsbruck, Innsbruck, Austria. michael.mitterberger@uibk.ac.at
Michael
M
Mitterberger
Germar-Michael
GM
Pinggera
Rainer
R
Marksteiner
Eva
E
Margreiter
Martin
M
Fussenegger
Ferdinand
F
Frauscher
Hanno
H
Ulmer
Steffen
S
Hering
Georg
G
Bartsch
Hannes
H
Strasser
D001706:Biopsy; D002478:Cells, Cultured; D004576:Electromyography; D019160:Endosonography; D005260:Female; D005347:Fibroblasts / Q000166:cytology / Q000637:transplantation*; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008875:Middle Aged; D032448:Myoblasts, Skeletal / Q000166:cytology / Q000637:transplantation*; D011788:Quality of Life; D033581:Stem Cell Transplantation / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014521:Urethra; D001743:Urinary Bladder; D014550:Urinary Incontinence, Stress / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics