ClinicalTrials.gov NCT01533038.

When germ-free cell cultures became a laboratory routine, hopes were high for using this novel technology for treatment of diseases or replacement of cells in patients suffering from injury, inflammation, or cancer or even refreshing cells in the elderly. Today, more than 50 years after the first successful bone marrow transplantation, clinical application of hematopoietic stem cells is a routine procedure, saving the lives of many every day. However, transplanting other than hematopoietic stem and progenitor cells is still limited to a few applications, and it mainly applies to mesenchymal stromal cells (MSCs) isolated from bone marrow. But research progressed and different trials explore the clinical potential of human MSCs isolated from bone marrow but also from other tissues including adipose tissue. Recently, MSCs isolated from bone marrow (bmMSCs) were shown to be a blend of distinct cells and MSCs isolated from different tissues show besides some common features also some significant differences. This includes the expression of distinct antigens on subsets of MSCs, which was utilized recently to define and separate functionally different subsets from bulk MSCs. We therefore briefly discuss differences found in subsets of human bmMSCs and in MSCs isolated from some other sources and touch upon how this could be utilized for cell-based therapies.

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Purpose-Urinary incontinence affects 40% of women in the United States and stress urinary incontinence accounts for a large portion of affected patients. As defined by the International Continence Society, stress urinary incontinence is the involuntary leakage of urine upon effort, exertion, sneezing or coughing. Since the ultimate success of long-term management for any condition is based on an understanding of its pathophysiology, and because the pathophysiology of stress urinary incontinence is incompletely defined, animal models have recently been developed to better understand stress urinary incontinence and develop novel treatment alternatives.Materials and Methods-Several animal models for urethral dysfunction have emerged in the last few years, including those based on pathophysiological theories of urethral sphincter dysfunction that were designed to simulate maternal birth trauma. Other models have focused on the creation of a durable model of dysfunction for investigating novel treatments.Results-Since animals cannot express intent, these animal models have focused on measuring decreased urethral resistance. The most widely used methods are the sneeze test, the tilt table technique and the leak point pressure test. Newer techniques include abdominal leak point pressure, urethral pressure measurement and retrograde urethral perfusion pressure. In addition to the advantages and disadvantages of each technique, all methods measure the composite contribution to urethral resistance from smooth and striated muscle, urethral closure and connective tissue, although none measures intent.Conclusions-We critically reviewed the different models of stress urinary incontinence and urethral dysfunction as well as the different methods of measuring urethral resistance. Keywords urethra; urinary incontinence; stress; female; urodynamics; models; animal Urinary incontinence affects 40% of women in the United States. SUI, the involuntary leakage of urine upon effort, exertion, sneezing or coughing, accounts for a large portion of affected patients. More than 165,000 surgical procedures are performed for SUI in the United States. It is estimated that a third of the procedures that are performed to treat SUI are done in patients with recurrent disease. These currently performed procedures for SUI are based on compensatory and nonphysiological mechanisms. Since the ultimate success of the long-term management of any condition is based on an understanding of its pathophysiology, and because †Correspondence:

The increased dosage of Tolterodine or Trospium is an effective treatment in patients with neurogenic bladder.

Aims To review the current state of research in the use of stem cells for stress urinary incontinence (SUI) and assess the likelihood of this becoming a relevant treatment option. Methods The peer-reviewed literature consisting of relevant clinical and animal studies on the topic of SUI was surveyed and reviewed. Results Animal studies have demonstrated the potential utility of stem cells in promoting functional recovery of the urethra after simulated childbirth injury. Research in animals suggests similar urethral recovery after injection of bone-marrow derived mesenchymal stem cell secretions as after injection of the stem cells themselves. Therefore, whether the improvements result from the injection of the stem cells themselves or from their secretion of specific proteins is unclear. Early clinical trials have demonstrated the feasibility and short-term safety of injecting muscle-derived stem cells into the urethra to treat SUI. Conclusions Larger and longer term clinical trials are needed. Nonetheless, efficacious stem cell based therapy for the treatment of SUI is practical, achievable and should be available as a treatment modality in the near future.

This is the first study demonstrating the clinical usefulness of Botox therapy in clinical practice. Successful treatment resulted in lower costs for NDO associated morbidity due to less need for incontinence aids and UTI medication.