210 PERIURETHRAL INJECTION OF AUTOLOGOUS ADIPOSE-DERIVED STEM CELLS FOR THE TREATMENT OF MALE STRESS URINARY INCONTINENCE: OUTCOME OF A PRELIMINARY CLINICAL TRIAL

Abstract

Listen

Translate article

You have accessJournal of UrologyStem Cell Research1 Apr 2012210 PERIURETHRAL INJECTION OF AUTOLOGOUS ADIPOSE-DERIVED STEM CELLS FOR THE TREATMENT OF MALE STRESS URINARY INCONTINENCE: OUTCOME OF A PRELIMINARY CLINICAL TRIAL Momokazu Gotoh, Tokunori Yamamoto, Yoshihisa Matsukawa, and Ryohei Hattori Momokazu GotohMomokazu Gotoh Nagoya, Japan More articles by this author , Tokunori YamamotoTokunori Yamamoto Nagoya, Japan More articles by this author , Yoshihisa MatsukawaYoshihisa Matsukawa Nagoya, Japan More articles by this author , and Ryohei HattoriRyohei Hattori Nagoya, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.263AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To report a novel cell therapy using autologous adipose-derived stem cells (ADSCs) for stress urinary incontinence caused by urethral sphincter deficiency and the early outcomes in 2 initial male patients undergoing periurethral injection of ADSCs. METHODS Two male patients with persistent stress urinary incontinence after prostate surgery (radical prostatectomy and holmium laser enucleation of the prostate) received treatment. After liposuction of 250 mL of adipose tissue from the abdomen, we isolated ADSCs from this tissue 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, this treatment is entirely autologous, requires no cell culture, and is performed in the context of a single surgical procedure. Outcomes during a 3-month follow-up were assessed by a 24-hour pad test, a validated patient questionnaire, urethral pressure profile, contrast-enhanced transrectal ultrasonography, and magnetic resonance imaging. The present study was approved by the Ethics Committee of the Nagoya University Graduate School of Medicine and by the Japanese government. RESULTS After injection, urinary incontinence progressively improved during the 3-month follow-up, i.e., decreased leakage volume in a 24-hour pad test. One patient with moderate incontinence (mean leakage amount per day during 4 consecutive days in a 24-hour pad test: 113.3 g) achieved total continence 14 weeks after injection. In another patient, the mean leakage amount per day has been improving from 49.5 to 12.3 g at 12 weeks after injection. In the urethral pressure profile, both maximum urethral closing pressure and functional profile length increased in both patients. Magnetic resonance imaging demonstrated sustained presence of the injected adipose tissue. Enhanced ultrasonography revealed a progressive increase in blood flow to the injected area. No significant adverse events were observed peri- and postoperatively. CONCLUSIONS This preliminary study demonstrated that periurethral injection of autologous ADSCs is a safe and feasible treatment modality for patients with stress urinary incontinence caused by urethral sphincter deficiency. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e87-e88 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Momokazu Gotoh Nagoya, Japan More articles by this author Tokunori Yamamoto Nagoya, Japan More articles by this author Yoshihisa Matsukawa Nagoya, Japan More articles by this author Ryohei Hattori Nagoya, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...