title: Adipose-Derived Regenerative Cell Injection Therapy for Postprostatectomy Incontinence: A Phase I Clinical Study.
abstract: OBJECTIVE
  We report our initial experience with transurethral injection of autologous adipose-derived regenerative cells (ADRCs) for the treatment of urinary incontinence after radical prostatectomy.
  
  
  METHODS
  After providing written informed consent, six men with persistent urinary incontinence after radical prostatectomy were enrolled in the study. Under general anesthesia, about 50 mL of adipose tissue was obtained from the patients by liposuction. ADRCs were obtained by separation with centrifugation using the Celution cell-processing device. A mixture of ADRCs and adipose tissue were transurethrally injected into the submucosal space of the membranous urethra. Functional and anatomical improvement was assessed using a 24-h pad test, validated patient questionnaire, urethral pressure profile, and magnetic resonance imaging (MRI) during 12-week follow-up.
  
  
  RESULTS
  Urine leakage volume was improved with time in all patients in the 24-h pad test, with the exemption of temporal deterioration at the first 2 weeks post-injection in 2 patients. Subjective symptoms and quality of life assessed on the basis of questionnaire results showed similar improvement. The mean maximum urethral closing pressure increased from 44.0 to 63.5 cm H₂O at 12 weeks after injection. MRI showed an increase in functional urethral length (from 6.1 to 8.3 mm) between the lower rim of the pubic bone and the bladder neck. Adverse events, such as pelvic pain, inflammation, or de novo urgency, were not observed in any case during follow-up.
  
  
  CONCLUSIONS
  This study demonstrated that transurethral injection of autologous ADRCs can be a safe and effective treatment modality for postprostatectomy incontinence.
authors.affiliation: Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea.
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea.
authors.forename: Tae Hwan
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.
authors.forename: Jung Dug
authors.initials: JD
authors.lastname: Yang
authors.affiliation: Department of Clinical Pathology, School of Medicine, Kyungpook National University, Daegu, Korea.
authors.forename: Jang Soo
authors.initials: JS
authors.lastname: Suh
authors.affiliation: Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea.|Joint Institute for Regenerative Medicine, Kyungpook National University Hospital, Daegu, Korea. tgkwon@knu.ac.kr.
authors.forename: Tae Gyun
authors.initials: TG
authors.lastname: Kwon
mesh_terms: D000273:Adipose Tissue / Q000166:cytology* / Q000637:transplantation; D000368:Aged; D005260:Female; D006801:Humans; D007267:Injections / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects*; D011788:Quality of Life; D033581:Stem Cell Transplantation / Q000379:methods*; D011795:Surveys and Questionnaires; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014521:Urethra / Q000000981:diagnostic imaging; D014549:Urinary Incontinence / Q000209:etiology / Q000628:therapy*
keywords: Urinary incontinence; adipose tissue; injections; regenerative medicine