Cell Injections for Urinary Incontinence

Robert W. Griffith, MD

There's an apparent breakthrough in the treatment of female urinary incontinence. Austrian researchers have taken cells from a woman's muscle tissue and grown them in cell culture to obtain myeloblasts and fibroblasts (primitive muscle and connective tissue cells). They theorized that, based on animal studies, the myloblasts could aid in regeneration of the 1½ centimeter ring of muscle around the urethra, which controls the passage of urine from the bladder, improving continence. They therefore injected myeloblasts into this muscle (called the rhabdosphincter) and fibroblasts into the connective tissue beneath the urethral wall, using ultrasound to guide the needle.

The researchers reported their findings in the Lancet. Sixty-three women with stress incontinence received either the cell treatment or the injection of collagen at the same site. Complete continence at 12-month follow-up was achieved by 38 of the 42 women injected with cells, and 2 of the 21 given collagen injections. This quite spectacular result was accompanied by similar differences favoring the cell treatment using incontinence scores, a voiding diary, pad counts, and so on. There were no side effects in any of the 63 women.

The only limitation in this study was the fact that it was not 'blinded' - i.e. the patients and their doctors knew which treatment each woman received. The investigators call for long-term postoperative results from multicenter studies with large numbers of patients before this approach becomes a standard way of treating urinary incontinence in women. And, of course, other candidate patients could be invited to try the treatment - patients with different types of incontinence, as well as men, who also have a rhabdosphincter.

Source
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