Autologous Adipose Stem Cells in Treatment of Female Stress Urinary Incontinence: Results of a Pilot Study

Stem Cells Transl Med. 2014 Aug;3(8):936-41. doi: 10.5966/sctm.2013-0197. Epub 2014 Jul 1.

Abstract

The purpose of our study was to find out whether transurethral injections of autologous adipose stem cells (ASCs) are an effective and a safe treatment for female stress urinary incontinence (SUI). We treated five SUI patients with ASCs combined with bovine collagen gel and saline. Prior to the treatment, the ASCs were isolated from subcutaneous fat and expanded for 3 weeks in a good manufacturing practice-level laboratory. The mixture of ASCs and collagen was injected transurethrally via cystoscope. Additionally, viability, multipotency, and surface marker profile of ASCs were analyzed in vitro. We followed up with patients 3, 6, and 12 months after the injections. The primary endpoint was a cough test to measure objectively the effect of the treatment. Validated questionnaires were used to determine the subjective cure rate. After 6 months, 1 of 5 patients displayed a negative cough test with full bladder filled with 500 ml of saline. At 1 year, the cough test was negative with three patients; two of them were satisfied with the treatment and did not wish further treatment for SUI. Validated questionnaires showed some subjective improvement in all five patients. This is the first study describing the use of autologous ASCs in combination with collagen gel for female SUI treatments. Thus far, the treatment with autologous ASCs has proven safe and well tolerated. However, the feasibility and efficacy of the treatment were not optimal; therefore, additional research is needed to develop SUI injection therapies.

Keywords: Adipose stem cells; Female incontinence; Injection therapy; Stress urinary incontinence; Tissue engineering.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Biomarkers / metabolism
  • Cell Separation
  • Cell Survival
  • Cells, Cultured
  • Collagen
  • Diagnostic Techniques, Urological
  • Female
  • Graft Survival
  • Humans
  • Middle Aged
  • Pilot Projects
  • Recovery of Function
  • Regeneration*
  • Regenerative Medicine / methods*
  • Stem Cell Transplantation*
  • Subcutaneous Fat / cytology*
  • Surveys and Questionnaires
  • Time Factors
  • Tissue Engineering / methods*
  • Tissue Scaffolds
  • Transplantation, Autologous
  • Treatment Outcome
  • Urethra / metabolism
  • Urethra / pathology
  • Urethra / physiopathology*
  • Urinary Incontinence, Stress / diagnosis
  • Urinary Incontinence, Stress / physiopathology
  • Urinary Incontinence, Stress / surgery*
  • Urodynamics

Substances

  • Biomarkers
  • glutaraldehyde-cross-linked collagen
  • Collagen