Strasser, H., Marksteiner, R., Margreiter, E., Pinggera, G.M., Mitterberger, M., Frauscher, F., Ulmer, H., Fussenegger, M., Kofler, K. and Bartsch, G.
Preclinical studies suggest that transurethral injections of autologous myoblasts may have a role in aiding the regeneration of the rhabdosphincter, and that fibroblasts may assist reconstruction of the urethral submucosa. This study compared the effectiveness and tolerability of ultrasonography-guided injections of autologous cells with those of endoscopic injections of collagen for stress incontinence.
63 women with urinary stress incontinence were recruited, of which 42 were randomly assigned to receive transurethral ultrasonography-guided injections of autologous myoblasts and fibroblasts. 21 were assigned to receive the conventional endoscopic injections of collagen. The main outcome measure used was an incontinence score based on 24hr voiding diary, 24hr pad test and a patient questionnaire, alongside contractility of the rhabdosphincter and thickness of the urethra and rhabdosphincter.
At 12 months follow up, 38 of the 42 women injected with the autologous cells were completely continent, compared with two of the 21 patients receiving conventional treatment with collagen. There were no adverse effects recorded in any of the 63 patients.
This study would suggest that injection with autologous cells may be a preferential treatment when compared against the conventional treatment using collagen. Further multicentre trials and long term follow up studies are required to assess whether this could become a standard treatment for urinary incontinence.
The Lancet 2007; 369:2179-2186