156 PERIURETHRAL INJECTION OF AUTOLOGOUS ADIPOSE-DERIVED STEM CELLS FOR THE TREATMENT OF STRESS URINARY INCONTINENCE IN PATIENTS UNDERGOING RADICAL PROSTATECTOMY: REPORT OF INITIAL TWO CASES

Abstract

You have accessJournal of UrologyStem Cell Research1 Apr 2010156 PERIURETHRAL INJECTION OF AUTOLOGOUS ADIPOSE-DERIVED STEM CELLS FOR THE TREATMENT OF STRESS URINARY INCONTINENCE IN PATIENTS UNDERGOING RADICAL PROSTATECTOMY: REPORT OF INITIAL TWO CASES Tokunori Yamamoto, Momokazu Gotoh, Yoshihisa Matsukawa, and Ryouhei Hattori Tokunori YamamotoTokunori Yamamoto More articles by this author , Momokazu GotohMomokazu Gotoh More articles by this author , Yoshihisa MatsukawaYoshihisa Matsukawa More articles by this author , and Ryouhei HattoriRyouhei Hattori More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.209AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To report a novel cell therapy using autologous adipose tissue-derived stem cells (ADSCs) for stress urinary incontinence caused by urethral sphincteric deficiency and the outcomes in 2 initial cases undergoing periurethral injection of stem cells for the treatment of urinary incontinence after radical prostatectomy. METHODS Two patients with moderate stress incontinence following radical prostatectomy were enrolled. After liposuction of 250 ml of adipose tissue from the abdomen, we isolated ADSCs from this tissue by using the CelutionTM system. Subsequently, the isolated ADSCs and a mixture of stem cells and adipose tissue were transurethrally injected into the rhabdosphincter and submucosal space of the urethra, respectively. Unlike other cell therapy strategies, this treatment is all autologous, requires no cell culture and is performed in the context of a single surgical procedure.Outcomes during a 6-month follow-up were assessed by a 24-hours pad test, a validated patient questionnaire, urethral pressure profile, contrast-enhanced transrectal ultrasonography by intravenously injecting perflubutane, and magnetic resonance imaging. The present study was approved by the Ethics Committee of the Nagoya University Graduate School of Medicine, and written informed consent was obtained from the patients. RESULTS Urinary incontinence progressively improved after 2 weeks of injection up to 6 months, in terms of decreased leakage volume in a 24-hour pad test, decreased frequency and amount of incontinence, and improved quality of life as per the questionnaire. One patient achieved total continence 6 months after injection. In urethral pressure profile, both maximum urethral closing pressure and functional profile length increased. Ultrasonography and magnetic resonance imaging demonstrated sustained presence of the injected adipose tissue. Enhanced ultrasonography revealed a progressive increase in the blood flow to the injected area. No significant adverse events were observed peri- and postoperatively. CONCLUSIONS This preliminary study demonstrated that periurethral injection of the autologous ADSCs is a safe and feasible treatment modality for stress urinary incontinence. Nagoya, Japan© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e63 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tokunori Yamamoto More articles by this author Momokazu Gotoh More articles by this author Yoshihisa Matsukawa More articles by this author Ryouhei Hattori More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...