title: Muscle-derived cell injection to treat anal incontinence due to obstetric trauma: pilot study with 1 year follow-up.
abstract: 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.
authors.affiliation: Obstetrics & Gynaecology, Medical University of Graz, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Frudinger
authors.forename: D
authors.initials: D
authors.lastname: Kölle
authors.forename: W
authors.initials: W
authors.lastname: Schwaiger
authors.forename: J
authors.initials: J
authors.lastname: Pfeifer
authors.forename: J
authors.initials: J
authors.lastname: Paede
authors.forename: S
authors.initials: S
authors.lastname: Halligan
mesh_terms: 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