MP30-13 USE OF UNIFORMLY SIZED MUSCLE FIBER FRAGMENTS FOR THE TREATMENT OF URINARY INCONTINENCE

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence: Therapy I (MP30)1 Apr 2020MP30-13 USE OF UNIFORMLY SIZED MUSCLE FIBER FRAGMENTS FOR THE TREATMENT OF URINARY INCONTINENCE In Kap Ko, Eun Sang Yoo, Sang Mi Park, Bu-Kyu Lee, John Jackson*, Ji Hyun Kim, James Yoo, and Anthony Atala In Kap KoIn Kap Ko More articles by this author , Eun Sang YooEun Sang Yoo More articles by this author , Sang Mi ParkSang Mi Park More articles by this author , Bu-Kyu LeeBu-Kyu Lee More articles by this author , John Jackson*John Jackson* More articles by this author , Ji Hyun KimJi Hyun Kim More articles by this author , James YooJames Yoo More articles by this author , and Anthony AtalaAnthony Atala More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000869.013AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Treatment of muscle function loss due to traumatic injury, congenital defects, or tumor ablations is clinically challenging. The current treatment standard is grafting of autologous muscle flaps, however significant donor site morbidity and graft tissue availability remain a problem. Alternatively, muscle fiber therapy has been attempted to treat muscle injury by transplanting single fibers into the defect site. However, irregularly organized long fibers resulted in low survivability due to delay in vascular and neural integration, thus limiting the therapeutic efficacy. Therefore, no effective method is available to permanently restore extensive muscle injuries. To address the current limitations, we developed a novel method that produces uniformly sized native muscle fiber fragments (MFFs) for muscle transplantation. We hypothesized that fragmentation of muscle fibers into small and uniformly sized fragments would allow for rapid reassembly and efficient engraftment within the defect site, resulting in accelerated recovery of muscle function. In this study, we applied autologous MFFs to restore sphincteric muscle anatomy and function for the treatment of urinary incontinence. METHODS: We developed an MFF processing method that produces uniformly sized fragments (approximately 100 μm in width and length) with intact muscle cells on the fiber surface. To test the therapeutic effects of the MFF technology, we created several rodent muscle injury models, including 1) a muscle atrophy model using toxin treatment such as barium chloride (BaCl2), 2) a volumetric muscle defect model by surgical ablation, and 3) urinary incontinence (UI) model by damaging the external sphincter of urethra. The effectiveness of the MFF therapy was determined by structural and functional recovery of muscle tissues in these models. RESULTS: The processed MFFs have a dimension of approximately 100 μm and contain living muscle cells on extracellular matrices (ECM). In preclinical animal studies using muscle atrophy, volumetric defect, and urinary incontinence models, histological and functional analyses confirmed that the transplanted MFFs into the injury sites were able to effectively integrate with host muscle tissue, vascular, and neural systems, which resulted in significant improvement of muscle function and mass. CONCLUSIONS: These results indicate that the MFF technology platform is a promising therapeutic option for the restoration of muscle function in several muscle defect models, including the urinary incontinence. The ease of preparation and short processing time makes this technology readily usable as a point of care procedure in the operating room. Source of Funding: Departmental funding © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e443-e443 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information In Kap Ko More articles by this author Eun Sang Yoo More articles by this author Sang Mi Park More articles by this author Bu-Kyu Lee More articles by this author John Jackson* More articles by this author Ji Hyun Kim More articles by this author James Yoo More articles by this author Anthony Atala More articles by this author Expand All Advertisement PDF downloadLoading ...