New Study for Stem Cells
A new study in Austria has indicated that injections of stem cells and other cells obtained from a woman’s own body can treat stress urinary incontinence with dramatically better results than conventional collagen injections. This new break through has still a long way to go in development and we still do not know what the long term results will be, but things are looking positive.
“The treatment might have a chance to be permanent,” Giacomo Novara, MD, a doctor at the University of Padua in Italy.Novara wrote a comment accompanying the study. Both appear in the June 30 issue of The Lancet. More than 4 million women in UK and 13 million women in the U.S on estimation around 20% of women in each country suffer from stress urinary incontinence (SUI), a condition much more common in women than in men.For futher information on Stress Incontinence click here
The Austrian Study (webmed.com)
“The Austrian researchers, led by Hannes Strasser, MD, from the Medical University of Innsbruck, compared the effects of the stem cell injections with conventional injections of collagen in 63 women with stress urinary incontinence. They first performed a small muscle biopsy on the upper arms of the 42 women assigned to get the stem cell injections. In the laboratory, they retrieved myoblasts, a type of muscle stem cell, and fibroblasts, cells which form the structural framework for many body tissues.Both types of cells have been shown effective in reconstructing the lower urinary tract in animal studies, according to Strasser.
Next, guided by ultrasound, Strasser’s team injected the cells back into the women’s sphincter and surrounding area. Traditional collagen injections, which don’t typically have a high success rate for incontinence, were given to the other 21 women. Collagen treatments work by bulking up the area to compress the urethra helping to hold urine. After 12 months, 38 of the 42 women given the stem cell and other cell injections were completely continent.
The other four showed either slight or substantial improvement. But just two of the 21 who got collagen injections were continent; seven others showed either slight or substantial improvement. On ultrasound exams after the injections, the thickness of the sphincter had increased 59% in the women given cell injections but just 9% in the collagen-treated group. The muscle contractibility rose much more in the cell group. Increases in the sphincter thickness and muscle contractibility are thought to help improve symptoms.Women treated with the injections of cells reported higher quality of life than the collagen-treated group.None of the women reported any adverse side effects.
The Austrian study shows “promising results,” according to Michael Chancellor, MD, a professor of urology and director of the neurourology and urinary incontinence programs at the University of Pittsburgh.
He has been conducting similar research and presented his findings in May 2007 at the annual meeting of the American Urological Association in Anaheim, Calif.
In that study, Chancellor and his colleagues injected adult stem cells derived from the person’s own muscle into the weakened sphincter and found after a year and half that five of the eight women with urinary incontinence studied got modest improvement; one woman was completely continent.The study was a safety study, considered preliminary, and done in cooperation with the University of Toronto and Health Canada. Urologists agree that better options are sorely needed for stress incontinence. Currently, doctors treating women with the condition suggest pelvic floor exercise or Kegels to strengthen the pelvic floor muscles, biofeedback to retrain the muscles, or a variety of surgical options. One procedure involves inserting a mesh-like tape that serves as a kind of sling to support the urethra and prevent the involuntary leakage of urine.”
How does it work?
If the patient is suitable for the therapy, a small muscle biopsy is taken from the upper arm as part of the therapy procedure.The tissue sample is then prepared in specialist laboratories. Specialists isolate the muscle cells (myoblasts) and the connective tissue cells (fibroblasts) contained in the tissue and multiply these cells using special procedures. As soon as there are a sufficient number of cells, the newly cultivated cells are injected into the patient’s damaged muscle with a specially developed, patented ultrasound probe.The clinical procedure lasts approximately 30 minutes.
The cells now integrate into the rhabdosphincter (Striated muscle forming the urethral rhabdosphincter and the periurethral striated muscle (part of the pelvic diaphragm) together make up the external urethral sphincter mechanism in humans. The rhabdosphicter in women forms a 1.5-cm long circular ring around the middle third of the urethra) improving its contractility, restoring the muscle’s original function of bladder control.
No immunological defence reaction of the body occurs because it is exclusively the patient’s own tissue that is used. The integration of the cells into the rhabdosphincter is supported by a special exercise programme.Within a short time the patient should be able to regain natural bladder control.
This treatment as promising as it sounds has still a long way to go before being used as a primary solution for stress incontinence.