Cell therapy for stress urinary incontinence: Present‐day frontiers

Abstract

Stress urinary incontinence (SUI) significantly diminishes the quality of patients' lives. Currently available surgical and nonsurgical therapies remain far from ideal. At present, advances in cellular technologies have stirred growing interest in the use of autologous cell treatments aimed to regain urinary control. The objective was to conduct a review of the literature and analyse preclinical and clinical studies dedicated to various cell therapies for SUI, assessing their effectiveness, safety, and future prospects. A systematic literature search in PubMed was conducted using the following key terms: "stem," "cell," "stress," "urinary," and "incontinence." A total of 32 preclinical studies and 15 clinical studies published between 1946 and December 2014 were included in the review. Most preclinical trials have used muscle-derived stem cells and adipose-derived stem cells. However, at present, the application of other types of cells, such as human amniotic fluid stem muscle-derived progenitor cells and bone marrow mesenchymal stromal cells, is becoming more extensive. While the evidence shows that these therapies are effective and safe, further work is required to standardize surgical techniques, as well as to identify indications for their use, doses and number of doses. Future research will have to focus on clinical applications of cell therapies; namely, it will have to determine indications for their use, doses of cells, optimal surgical techniques and methods, attractive cell sources, as well as to develop clinically relevant animal models and make inroads into understanding the mechanisms of SUI improvement by cell therapies.

Limited accuracy of transurethral and periurethral intrasphincteric injections of cellular suspension

“…There are over 30 papers describing experiments in which functional assessment was performed after transplantation of cells into the experimentally injured urethra in small animal models. Interestingly, regardless of cell type, dose and other differences between protocols, all authors reported functional improvement after cell therapy in comparison to the control groups . These results encouraged clinical trials.…”

“…Interestingly, regardless of cell type, dose and other differences between protocols, all authors reported functional improvement after cell therapy in comparison to the control groups. 1 These results encouraged clinical trials. Since 2007 more than 15 papers presenting results of cell therapy in SUI patients have been published.…”

Applicability of regenerative medicine and tissue engineering for the treatment of stress urinary incontinence in female patients

“…Stem cells have been used for more than 40 years for the treatment of hematologic diseases. Nevertheless, their multitherapeutic potential was reported only in 1999 when the cover of Science magazine announced, “Breakthrough of the year: stem cells show their therapeutic potential.” In recent years, the use of autologous stem cells aiming to halt disease progression and reverse underlying physiopathology of SUI has emerged as a promising approach to restore the anatomy and functionality of urinary sphincter and repair the neuropraxia …”

“…24 In recent years, the use of autologous stem cells aiming to halt disease progression and reverse underlying physiopathology of SUI has emerged as a promising approach to restore the anatomy and functionality of urinary sphincter and repair the neuropraxia. 25 2.7 | Bone marrow, amniotic fluid, and human cord blood-derived mesenchymal stem cells for SUI By definition, mesenchymal stem cells (MSCs) are multipotent stromal cells that can differentiate into a variety of cells, such as chondrocytes, myocytes, and adipocytes. MSCs can be isolated from all tissues derived from mesoderms, such as bone marrow, amniotic fluid, blood, adipose, cartilage, and skeletal muscle tissue.…”

Letter to the editor on “Cell therapy for stress urinary incontinence: Present‐day frontiers”

“…We read with great interest the article by Vinarov et al (), in a recent issue of the journal. We believe this is the first review article on cell therapy for stress urinary incontinence (SUI), and it is very informative for researchers and clinicians in that area.…”