title: Towards a Treatment of Stress Urinary Incontinence: Application of Mesenchymal Stromal Cells for Regeneration of the Sphincter Muscle.
abstract: Stress urinary incontinence is a significant social, medical, and economic problem. It is caused, at least in part, by degeneration of the sphincter muscle controlling the tightness of the urinary bladder. This muscular degeneration is characterized by a loss of muscle cells and a surplus of a fibrous connective tissue. In Western countries approximately 15% of all females and 10% of males are affected. The incidence is significantly higher among senior citizens, and more than 25% of the elderly suffer from incontinence. When other therapies, such as physical exercise, pharmacological intervention, or electrophysiological stimulation of the sphincter fail to improve the patient's conditions, a cell-based therapy may improve the function of the sphincter muscle. Here, we briefly summarize current knowledge on stem cells suitable for therapy of urinary incontinence: mesenchymal stromal cells, urine-derived stem cells, and muscle-derived satellite cells. In addition, we report on ways to improve techniques for surgical navigation, injection of cells in the sphincter muscle, sensors for evaluation of post-treatment therapeutic outcome, and perspectives derived from recent pre-clinical studies.
authors.affiliation: KFO273, Department of Urology, University of Tuebingen Hospital, Tuebingen 72076, Germany. kfo273@med.uni-tuebingen.de.
authors.forename: Wilhelm K
authors.initials: WK
authors.lastname: Aicher
authors.affiliation: KFO273, Department of Urology, University of Tuebingen Hospital, Tuebingen 72076, Germany. melaniehar@googlemail.com.
authors.forename: Melanie L
authors.initials: ML
authors.lastname: Hart
authors.affiliation: FRAUNHOFER Institute, Klinikum Mannhein, Mannheim 68167, Germany. jan.stallkamp@ipa.fraunhofer.de.
authors.forename: Jan
authors.initials: J
authors.lastname: Stallkamp
authors.affiliation: Department for Systems Dynamics, University of Stuttgart, Stuttgart 70569, Germany. mario.kluender@isys.uni-stuttgart.de.
authors.forename: Mario
authors.initials: M
authors.lastname: Klünder
authors.affiliation: Department for Systems Dynamics, University of Stuttgart, Stuttgart 70569, Germany. michael.ederer@isys.uni-stuttgart.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Ederer
authors.affiliation: Department for Systems Dynamics, University of Stuttgart, Stuttgart 70569, Germany. oliver.sawodny@isys.uni-stuttgart.de.
authors.forename: Oliver
authors.initials: O
authors.lastname: Sawodny
authors.affiliation: KFO273, Department of Urology, University of Tuebingen Hospital, Tuebingen 72076, Germany. martin.vaegler@med.uni-tuebingen.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Vaegler
authors.affiliation: KFO273, Department of Urology, University of Tuebingen Hospital, Tuebingen 72076, Germany. bastian.amend@med.uni-tuebingen.de.|Department of Urology, University of Tuebingen Hospital, Tuebingen 72076, Germany. bastian.amend@med.uni-tuebingen.de.
authors.forename: Bastian
authors.initials: B
authors.lastname: Amend
authors.affiliation: KFO273, Department of Urology, University of Tuebingen Hospital, Tuebingen 72076, Germany. karl.sievert@med.uni-tuebingen.de.|Department of Urology, University of Tuebingen Hospital, Tuebingen 72076, Germany. karl.sievert@med.uni-tuebingen.de.
authors.forename: Karl D
authors.initials: KD
authors.lastname: Sievert
authors.affiliation: KFO273, Department of Urology, University of Tuebingen Hospital, Tuebingen 72076, Germany. arnulf.stenzl@med.uni-tuebingen.de.|Department of Urology, University of Tuebingen Hospital, Tuebingen 72076, Germany. arnulf.stenzl@med.uni-tuebingen.de.
authors.forename: Arnulf
authors.initials: A
authors.lastname: Stenzl
keywords: cell injection techniques; mesenchymal stem cells; mesenchymal stromal cells; stem cell application; urinary stress incontinence; urodynamics