Thérapie cellulaire et incontinence urinaire

Abstract

The objective of the current study was to perform a review of literature concerning stem cells therapy (preclinical and clinical studies) applied to the treatment of stress urinary incontinence (SUI). Review of literature (Pubmed/Medline) using the following key words: stem cells, urinary incontinence, stress. Among 38 published articles (English or French language), 16 studies were selected (comparative preclinical and clinical studies). Multipotentes mesenchymal stem cells (MSC), present in the adults in most of the tissues derived from the mesoderm have been tested in the treatment of SUI. Three sources of MSC have been mainly used in urology: bone marrow, striated muscle and adipose tissue. The general principle consists in extracting the MSC from the source tissue and grafting these MSC in the injured urinary sphincter. The preclinical studies proved the capacity of these transplanted cells to differenciate into contractile myocytes and to reconstitute nerve junctions. Clinical studies are very different in terms of methodology, with sample size ranging from four to 123 subjects and a median follow-up of 1 year; these studies showed success rates (complete continence) ranging from 12 to 79 % and improvement rates (quality of life and/or pad test) from 13 to 66%. Only one study reported two cases of worsening incontinence after cell therapy. The few available clinical studies have reported that at short-term follow-up, cell therapy was associated with encouraging results with few side effects.