Stem cell hope for urinary incontinence

Women’s own bodies may hold the key to their recovery from incontinence, researchers say. In a small study presented November 29 at the Radiological Society of North America annual meeting in Chicago, Austrian researchers successfully used their patients’ own stem cells to treat urinary incontinence.
The therapy is a potentially long-lasting one, with patients remaining continent one year after treatment.

Although the technique needs to be studied in more women and for longer periods of time, Dr Joe Littlejohn, a clinical instructor of urology at Columbia University College of Physicians and Surgeons in New York City, called the results “very promising.”

Stem cells are unspecialised cells that eventually grow into the myriad specific cells the body needs for specific functions.

Stress incontinence, the form of incontinence treated in this study, affects almost 15 million people worldwide, most of them women. Often the condition is a result of childbirth or ageing. It occurs when problems with the urethra or the sphincter muscles that help open and close the urethra cause urine leakage. Current therapies range from pelvic floor exercises to collagen injections to surgery, Littlejohn said.

These researchers built on preliminary studies already conducted, which used adult muscles derived from stem cells to reconstruct the lower urinary tract.
For this particular study, the authors removed stem cells from the arms of 20 females, aged 36 to 84, who were experiencing stress incontinence. The stem cells were cultured, producing tens of millions of new cells, then injected into the wall of the urethra and into the sphincter muscle.

“The good thing about this new procedure is it’s less invasive and the stem cells are harvested from the patient’s own body, so you don’t have to worry about rejection,” Littlejohn said. The cells also stayed where they had been injected and, when enough muscle had been formed, stopped growing.

All the women in the study experienced enhanced muscle mass and contractility of the sphincter and a thicker urethra. The procedure, which was done on an outpatient basis, took 15 to 20 minutes to complete. At one year after the initial procedure, 18 of the 20 participants remained continent.
The researchers are still following the participants with the longest follow-up, who were treated as far back as October 2002. “We still have good results,” study author Dr Ferdinand Frauscher said.

Frauscher, head of uroradiology at University Hospital in Innsbruck, Austria, said his team has plans to start using this technique at other centres. “Next year we will start in three centres in Austria, two in Germany, one in Switzerland and one in the Netherlands,” he said. “We are also planning to perform this in the USA.”

To become widely available, centres would need to be able to perform ultrasounds to help determine where to place the stem cells as well as a lab for stem cells to be cultured.

Frauscher said the procedure has also been tried in a few men after prostate surgery. “It should work well, especially after radical prostatectomy, because the sphincter is one of the most important muscles for maintaining continence,” he said. “However, if there are large video porno gratis, this might be a limitation.”

Frauscher is a consultant for InnovaCell, which produces the stem cells. Two other authors of the study are owners of the company.