title: Bladder recovery by stem cell based cell therapy in the bladder dysfunction induced by spinal cord injury: systematic review and meta-analysis.
abstract: BACKGROUND
  Bladder dysfunction induced by spinal cord injury (SCI) can become problematic and severely impair the quality of life. Preclinical studies of spinal cord injury have largely focused on the recovery of limb function while neglecting to investigate bladder recovery.
  
  
  OBJECTIVE
  The present study was performed to investigate and review the effect of stem cell-based cell therapy on bladder recovery in SCI.
  
  
  METHODS
  We conducted a meta-analysis of urodynamic findings of experimental trials that included studies of stem cell-based cell therapy in SCI. Relevant studies were searched using MEDLINE, EMBASE and Cochrane Library (January 1990 - December 2012). Final inclusion was determined by a urodynamic study involving detailed numerical values. Urodynamic parameters for analysis included voiding pressure, residual urine, bladder capacity and non-voiding contraction (NVC). Meta-analysis of the data, including findings from urodynamic studies, was performed using the Mantel-Haenszel method.
  
  
  RESULTS
  A total of eight studies were included with a sample size of 224 subjects. The studies were divided into different subgroups by different models of SCI. After a stem cell-based cell therapy, voiding pressure (-6.35, p <0.00001, I2 = 77%), NVC (-3.58, p <0.00001, I2 = 82%), residual urine (-024, p = 0.004, I2 = 95%) showed overall significant improvement. Bladder capacity showed improvement after treatment only in the transection type (-0.23, p = 0.0002, I2 = 0%).
  
  
  CONCLUSIONS
  After stem cell-based cell therapy in SCI, partial bladder recovery including improvement of voiding pressure, NVC, and residual urine was demonstrated. Additional studies are needed to confirm the detailed mechanism and to obtain an ideal treatment strategy for bladder recovery.
authors.affiliation: Department of Urology, Soonchunyang University Hospital, Soonchunhyang University School of Medicine, Seoul, Korea.
authors.forename: Jae Heon
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Institute for clinical molecular biology research, Soonchunyang University Hospital, Soonchunhyang University School of Medicine, Seoul, Korea.
authors.forename: Sung Ryul
authors.initials: SR
authors.lastname: Shim
authors.affiliation: Department of Urology, Soonchunyang University Hospital, Soonchunhyang University School of Medicine, Seoul, Korea.
authors.forename: Seung Whan
authors.initials: SW
authors.lastname: Doo
authors.affiliation: Department of Urology, Soonchunyang University Hospital, Soonchunhyang University School of Medicine, Seoul, Korea.
authors.forename: Won Jae
authors.initials: WJ
authors.lastname: Yang
authors.affiliation: Department of Family Medicine, Soonchunhyang University School of Medicine, Seoul, Korea.
authors.forename: Byung Wook
authors.initials: BW
authors.lastname: Yoo
authors.affiliation: International Clinic Center, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Joyce Mary
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Industrial and Management Engineering, Pohang University of Science and Technology, Pohang, Korea.
authors.forename: Young Myoung
authors.initials: YM
authors.lastname: Ko
authors.affiliation: Department of Obstetrics and Gynecology, Inha University School of Medicine, Incheon, Korea.
authors.forename: Eun Seop
authors.initials: ES
authors.lastname: Song
authors.affiliation: Department of Industrial Management and Engineering, Namseoul University College of Engineering, Cheonan, Korea.
authors.forename: Ik Sung
authors.initials: IS
authors.lastname: Lim
authors.affiliation: Medical Research Institute, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Hong Jun
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Urology, Soonchunyang University Hospital, Soonchunhyang University School of Medicine, Seoul, Korea.
authors.forename: Yun Seob
authors.initials: YS
authors.lastname: Song
mesh_terms: D000818:Animals; D006801:Humans; D020127:Recovery of Function; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000628:therapy*; D033581:Stem Cell Transplantation / Q000379:methods*; D001743:Urinary Bladder / Q000503:physiopathology*