title: Regenerative treatment of male stress urinary incontinence by periurethral injection of autologous adipose-derived regenerative cells: 1-year outcomes in 11 patients.
abstract: OBJECTIVE
  To assess the efficacy and safety of a novel cell therapy for male stress urinary incontinence consisting of periurethral injection of autologous adipose-derived regenerative cells, and to determine the 1-year outcomes.
  
  
  METHODS
  A total of 11 male patients with persistent stress urinary incontinence after prostate surgery were included in the study. The Celution system was used to isolate adipose-derived regenerative cells from abdominal adipose tissue obtained by liposuction. Subsequently, these regenerative cells, and a mixture of regenerative cells and adipose tissue were transurethrally injected into the rhabdosphincter and submucosal space of the urethra, respectively. The 1-year outcomes were assessed using a 24-h pad test, a validated patient questionnaire, urethral pressure profile, transrectal ultrasonography and magnetic resonance imaging.
  
  
  RESULTS
  Stress urinary incontinence improved progressively in eight patients during the 1-year follow up, as determined by a 59.8% decrease in the leakage volume in the 24-h pad test, decreased frequency and amount of incontinence, and improved quality of life. One patient achieved total continence. The mean maximum urethral closing pressure and functional profile length increased from 35.5 to 44.7 cmH₂O, and from 20.4 to 26.0 mm, respectively. Magnetic resonance imaging showed the sustained presence of the injected adipose tissue, and enhanced ultrasonography showed a progressive increase in blood flow to the injected area in all patients. No significant adverse events were observed peri- or postoperatively.
  
  
  CONCLUSIONS
  Periurethral injection of autologous adipose-derived regenerative cells might represent a safe and feasible treatment modality for male stress urinary incontinence.
authors.affiliation: Department of Urology, Center for Advanced Medicine and Clinical Research, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Momokazu
authors.initials: M
authors.lastname: Gotoh
authors.forename: Tokunori
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Masashi
authors.initials: M
authors.lastname: Kato
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Majima
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Toriyama
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Kamei
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Matsukawa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hirakawa
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Funahashi
mesh_terms: D000273:Adipose Tissue / Q000166:cytology*; D000368:Aged; D000369:Aged, 80 and over; D017690:Cell Transplantation; D006801:Humans; D007267:Injections / Q000379:methods; D008297:Male; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014521:Urethra; D014550:Urinary Incontinence, Stress / Q000601:surgery*
keywords: adipose-derived regenerative cells; adipose-derived stem cells; cell therapy; prostatectomy; stress urinary incontinence