title: Cell Therapy for Stress Urinary Incontinence.
abstract: Urinary incontinence (UI) is the involuntary loss of urine and is a common condition in middle-aged and elderly women and men. Stress urinary incontinence (SUI) is caused by leakage of urine when coughing, sneezing, laughing, lifting, and exercise, even standing leads to increased intra-abdominal pressure. Other types of UI also exist such as urge incontinence (also called overactive bladder), which is a strong and unexpected sudden urge to urinate, mixed forms of UI that result in symptoms of both urge and stress incontinence, and functional incontinence caused by reduced mobility, cognitive impairment, or neuromuscular limitations that impair mobility or dexterity. However, for many SUI patients, there is significant loss of urethral sphincter muscle due to degeneration of tissue, the strain and trauma of pregnancy and childbirth, or injury acquired during surgery. Hence, for individuals with SUI, a cell-based therapeutic approach to regenerate the sphincter muscle offers the advantage of treating the cause rather than the symptoms. We discuss current clinically relevant cell therapy approaches for regeneration of the external urethral sphincter (striated muscle), internal urethral sphincter (smooth muscle), the neuromuscular synapse, and blood supply. The use of mesenchymal stromal/stem cells is a major step in the right direction, but they may not be enough for regeneration of all components of the urethral sphincter. Inclusion of other cell types or biomaterials may also be necessary to enhance integration and survival of the transplanted cells.
authors: 1 Clinical Research Group KFO 273, Department of Urology, University of Tübingen , Tübingen, Germany .
authors: Melanie L
authors: ML
authors: Hart
authors: 2 Tissue Engineering Laboratory, Instituto Biodonostia, Hospital Universitario Donostia , San Sebastian, Spain .
authors: Ander
authors: A
authors: Izeta
authors: 3 Urology Unit Research Virgen de la Victoria Hospital , Malaga, Spain .
authors: Bernardo
authors: B
authors: Herrera-Imbroda
authors: 4 Department of Urology, University of Tübingen , Tuebingen, Germany .
authors: Bastian
authors: B
authors: Amend
authors: 5 Department of Immunology, Oslo University Hospital, Oslo, Norway .|6 Norwegian Center for Stem Cell Research, Institute of Basic Medical Sciences, University of Oslo , Oslo, Norway .
authors: Jan E
authors: JE
authors: Brinchmann
mesh_terms: D002470:Cell Survival; D064987:Cell- and Tissue-Based Therapy; D006801:Humans; D012038:Regeneration; D013569:Synapses / Q000502:physiology; D014521:Urethra / Q000473:pathology; D014550:Urinary Incontinence, Stress / Q000473:pathology / Q000628:therapy*