Treatment of Stress Urinary Incontinence with Muscle Stem Cells and Stem Cell Components: Chances, Challenges and Future Prospects

Schmid, Florian; Williams, J. Koudy; Kessler, Thomas M.; Stenzl, Arnulf; Aicher, Wilhelm K.; Andersson, Karl‐Erik; Eberli, Daniel

doi:10.3390/ijms22083981

Cited by 20 publications

(25 citation statements)

References 133 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…SUI cell therapies may support self-healing of the urethral sphincter muscle by activating local satellite cells 7 , by improving vascularization and reducing inflammation 41 , 42 , or by complementing the deficient sphincter muscle by myogenic cells 5 , 13 – 15 , 43 , 44 . But these processes may take some time.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Replacing Needle Injection by a Novel Waterjet Technology Grants Improved Muscle Cell Delivery in Target Tissues

et al. 2022

Self Cite

View full text Add to dashboard Cite

Current regimen to treat patients suffering from stress urinary incontinence often seems not to yield satisfactory improvement or may come with severe side effects. To overcome these hurdles, preclinical studies and clinical feasibility studies explored the potential of cell therapies successfully and raised high hopes for better outcome. However, other studies were rather disappointing. We therefore developed a novel cell injection technology to deliver viable cells in the urethral sphincter complex by waterjet instead of using injection needles. We hypothesized that the risk of tissue injury and loss of cells could be reduced by a needle-free injection technology. Muscle-derived cells were obtained from young male piglets and characterized. Upon expansion and fluorescent labeling, cells were injected into cadaveric tissue samples by either waterjet or injection needle. In other experiments, labeled cells were injected by waterjet in the urethra of living pigs and incubated for up to 7 days of follow-up. The analyses documented that the cells injected by waterjet in vitro were viable and proliferated well. Upon injection in live animals, cells appeared undamaged, showed defined cellular somata with distinct nuclei, and contained intact chromosomal DNA. Most importantly, by in vivo waterjet injections, a significantly wider cell distribution was observed when compared with needle injections ( P < .05, n ≥ 12 samples). The success rates of waterjet cell application in living animals were significantly higher (≥95%, n = 24) when compared with needle injections, and the injection depth of cells in the urethra could be adapted to the need by adjusting waterjet pressures. We conclude that the novel waterjet technology injects viable muscle cells in tissues at distinct and predetermined depth depending on the injection pressure employed. After waterjet injection, loss of cells by full penetration or injury of the tissue targeted was reduced significantly in comparison with our previous studies employing needle injections.

show abstract

Section: Discussionmentioning

confidence: 99%

“…SUI is caused by a functional deficiency of the urethral sphincter complex. This may stem from loss of muscle tissue, apoptosis of muscle cells, or loss of muscular enervation 5 . When diagnosed in time, physical exercise of lower pelvic floor muscles may improve sphincter function.…”

Section: Introductionmentioning

confidence: 99%

Replacing Needle Injection by a Novel Waterjet Technology Grants Improved Muscle Cell Delivery in Target Tissues

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Não existe tratamento farmacológico aprovado para incontinência urinária de esforço pelo FDA, entretanto, existe medicamentos que podem ser utilizados para IUM (agentes anticolinérgicos e / ou agonistas do receptor beta-3) ou de suporte (inibidores seletivos da serotonina noradrenalina, estrogênios e desmopressina).Os tratamentos cirúrgicos podem ser a base de terapia de injeção parauretral, fitas vaginais livres de tensão, faixas uretrais pubovaginais ou uretrais médias, colposuspensão de Burch, sistemas de compressão e esfíncter urinário artificial. 1,5,6,7 O tratamento da IUU tem como objetivo reduzir a hiperatividade do detrusor. Isso pode ser feito por treinamento vesical, exercícios de Kegel, biofeedback e técnicas de relaxamento.…”

Section: Desenvolvimentounclassified

“…Já o tratamento cirúrgico pode incluir sling, colposuspensoes, agentes de volume e esfíncteres urinários artificiais.Ainda assim, há uma necessidade de tratamentos alternativos que sejam eficazes, minimamente invasivos e com risco limitado de efeitos adversos. 7…”

Section: Introductionunclassified

Incontinência urinária: revisão de literatura/ Urinary incontinence: literature review

Tozzi¹,

Olmo²,

Proescholdt³

et al. 2021

BJDV

View full text Add to dashboard Cite

Introdução: A incontinência urinária é a perda urinária de urina, podendo ser de esforço ou de urgência. Essa condição clinica está associada a um grande impacto na qualidade de vida, causando constrangimento, isolamento e depressão. Objetivos: O objetivo desse estudo é revisar sobre o manejo doa incontinência urinaria, visto ser uma doença de alta prevalência e impacto sócio econômico. Métodos: Os bancos de dados Pubmed, Scielo e diretrizes foram pesquisados eletronicamente utilizando os descritores incontinência urinaria, incontinência urinária de esforço e incontinência urinária de urgência nos idiomas inglês e português. Discussão e Conclusão: A incontinência urinaria, independente da sua forma apresentada, apresenta a obesidade e a idade como fatores de risco para o desenvolvimento. Dessa forma, como ambas condições estão cada vez mais prevalentes em nossa sociedade, torna-se necessária a prevenção e o diagnóstico precoces dessa condição clínica para tratamento efetivo.Palavras-chaves: incontinência urinaria, incontinência urinária de esforço e incontinência urinária de urgência ABSTRACT Introduction: Urinary incontinence is the urinary loss of urine, which may be due to effort or urgency. This clinical condition is associated with a great impact on quality of life, causing embarrassment, isolation and depression. Objectives: The aim of this study is to review the management of urinary incontinence, as it is a disease of high prevalence and socio-economic impact. Methods: The Pubmed, Scielo and guidelines databases were searched electronically using the descriptors urinary incontinence, stress urinary incontinence and urge urinary incontinence in English and Portuguese. Discussion and Conclusion: Urinary incontinence, regardless of its form, presents obesity and age as risk factors for development. Thus, as both conditions are increasingly prevalent in our society, prevention and early diagnosis of this clinical condition for effective treatment becomes necessary.

show abstract

“…For the treatment of stress urinary incontinence, of particular interest is the implantation of autologous muscle stem cells into the sphincter area to strengthen and restore its function. In rats, injected muscle-derived SC led to the formation of myotubes and myofibers [ 12 ]. Moreover, autologous muscle-derived SCs were able to restore damaged urinary sphincter function with up to 80% of the initial closure pressure values [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Stem Cells in Clinical Trials for Pelvic Floor Disorders: a Systematic Literature Review

et al. 2021

View full text Add to dashboard Cite

Pelvic floor disorders (PFDs) include a series of conditions that can be poorly tolerated, negatively affecting the quality of life. Current treatment options show unsatisfactory results and new ones are therefore needed. Stem cell (SC) therapy might be an alternative treatment strategy. This systematic review aims to define the state of art of SC therapy for PFDs in clinical trials, by systematically reviewing the available evidence. A systematic search strategy was conducted up to November 7, 2020, in PubMed, Scopus, Cochrane Library, and ISI Web of Science. Preclinical studies on animal models were not considered. Studies were included when the patients were affected by any PFDs and cells were isolated, cultured, and characterized as SC. The study protocol was registered in PROSPERO (CRD42020216551). A total of 11 prospective clinical studies were included in the final assessment, specifically 7 single-arm studies dealing with SC therapy for stress urinary incontinence and 4 with anal incontinence. Among the latter, there were two prospective, single-arm studies and two randomized controlled trials. No papers concerning the use of SC for prolapse repair were retrieved. Due to the great heterogeneity, data pooling was not possible. Stem cell injection resulted in a safe procedure, with few mild adverse side effects, mostly related to harvesting sites. However, a clear beneficial impact of SC treatment for the treatment of pelvic floor disorders could not be demonstrated. Further larger targeted studies with control arms are needed before any conclusions can be made.

show abstract

Treatment of Stress Urinary Incontinence with Muscle Stem Cells and Stem Cell Components: Chances, Challenges and Future Prospects

Cited by 20 publications

References 133 publications

Replacing Needle Injection by a Novel Waterjet Technology Grants Improved Muscle Cell Delivery in Target Tissues

Replacing Needle Injection by a Novel Waterjet Technology Grants Improved Muscle Cell Delivery in Target Tissues

Incontinência urinária: revisão de literatura/ Urinary incontinence: literature review

Stem Cells in Clinical Trials for Pelvic Floor Disorders: a Systematic Literature Review

Contact Info

Product

Resources

About