Periurethral injection of autologous adipose‐derived regenerative cells for the treatment of male stress urinary incontinence: Report of three initial cases

Abstract

Objectives: To report a novel cell therapy using autologous adipose tissue‐derived regenerative cells for male stress urinary incontinence caused by urethral sphincteric deficiency, and the outcomes in the initial cases undergoing periurethral injection of adipose tissue‐derived regenerative cells. Methods: Three patients with moderate stress incontinence after radical prostatectomy and holmium laser enucleation of the prostate were enrolled. Adipose tissue‐derived regenerative cells were isolated from the abdominal adipose tissue by using the Celution system. Subsequently, the isolated adipose tissue‐derived regenerative cells, and a mixture of adipose tissue‐derived regenerative cells and adipose tissue were transurethrally injected into the rhabdosphincter and submucosal space of the urethra, respectively. Short‐term outcomes during a 6‐month follow up were assessed by a 24‐h pad test, a validated patient questionnaire, urethral pressure profile, transrectal ultrasonography and magnetic resonance imaging. Results: Urinary incontinence progressively improved after 2 weeks of injection up to 6 months in terms of decreased leakage volume, decreased frequency and amount of incontinence, and improved quality of life. Both maximum urethral closing pressure and functional profile length increased. Magnetic resonance imaging suggested a sustained presence of the injected adipose tissue. Enhanced ultrasonography showed a progressive increase in the blood flow to the injected area. No significant adverse events were observed peri‐ and postoperatively. Conclusion: These preliminary findings suggest that periurethral injection of the autologous adipose tissue‐derived regenerative cells is a safe and feasible treatment modality for male stress urinary incontinence.

Stem cell augmented mesh materials: an in vitro and in vivo study

“…In pelvic floor dysfunctions, MSCs have been successfully used in the treatment of stress urinary incontinence [22]. In this study we confirmed the feasibility of incorporating rMSCs on both synthetic and biological prosthetic materials commonly used in pelvic reconstructive surgery.…”

Improvement of Anal Function by Adipose-Derived Stem Cell Sheets

“…Although, the possibility of smooth muscle regeneration was suggested, the mechanism for functional recovery was unclear. It was reported that in the experience of stress urinary incontinence, functional recovery might be achieved due to the bulking effect [20]. Further study is therefore still required to elucidate the function of regenerated smooth muscle.…”

The Celution®System: Automated Processing of Adipose-Derived Regenerative Cells in a Functionally Closed System

“….draws from a larger body of published clinical experience of any automated adipose tissue processing device, including areas as diverse as cardiology, 17 stress urinary incontinence, 35 breast reconstruction, 18 cryptoglandular fistula-in-ano, 36 and healing of refractory cutaneous wounds. 24,25,37 …”