Muscle-derived cell injection to treat anal incontinence due to obstetric trauma: pilot study with 1 year follow-up.
OBJECTIVE
To treat anal incontinence due to obstetric external anal sphincter disruption via injection of autologous myoblast cells.


METHODS
Observational pilot study.


METHODS
University hospital and district hospital


METHODS
10 women suffering from anal incontinence due to obstetric anal sphincter injury, refractory to conventional non-surgical therapy.


METHODS
Autologous myoblasts were cultured from a pectoralis muscle biopsy, harvested, and injected into the external anal sphincter defect using direct ultrasound guidance.


METHODS
Wexner incontinence score, anal squeeze pressures, and quality of life 12 months after injection. Safety and technical feasibility.


RESULTS
The procedure was well tolerated and no adverse events were observed. At 12 months the Wexner incontince score had decreased by a mean of 13.7 units (95% CI, -16.3 to -11.2), anal squeeze pressures were unchanged, and overall quality of life scores improved by a median of 30 points (95% CI, 25 to 42). Anal squeeze pressures did rise significantly at 1 month and 6 months post-injection (p = 0.03).


CONCLUSIONS
Injection of autologous myoblasts is safe, well tolerated, and significantly improves symptoms of anal incontinence due to obstetric anal sphincter trauma.
Frudinger
A
A
Obstetrics & Gynaecology, Medical University of Graz, Austria.
Kölle
D
D
Schwaiger
W
W
Pfeifer
J
J
Paede
J
J
Halligan
S
S
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology; D018929:Cell Culture Techniques; D019160:Endosonography; D004812:Epidemiologic Methods; D005242:Fecal Incontinence / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D032448:Myoblasts, Skeletal / Q000637:transplantation*; D007744:Obstetric Labor Complications; D011247:Pregnancy; D011312:Pressure; D011594:Psychometrics; D011788:Quality of Life; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional