Stem Cell Treatment Appears Efficacious for Stress Incontinence

Peggy Peck

November 30, 2004

Nov. 30, 2004 (Chicago) — Preliminary research suggests that stem cell therapy is a viable and efficacious treatment for stress urinary incontinence, according to results presented here at the 90th scientific assembly and annual meeting of the Radiological Society of North America.

"We believe we have developed a long-lasting and effective treatment that is especially promising because it is generated from the patient's own body," said Ferdinand Frauscher, MD, associate professor of radiology at the Medical University of Innsbruck, Austria. In the study, women who had autologous adult stem cells implanted into the rhabdosphincter were free of incontinence for a year or longer, he said.

Dr. Frauscher and colleagues enrolled 20 women aged 36 to 84 years who had clinically confirmed stress incontinence. Skeletal stem cells were extracted from patients’ arms and then cultured for six weeks until there were roughly 50 million myoblasts and an equal number of fibroblasts. Under ultrasound guidance, the cells were injected into the wall of the urethra and into the sphincter.

The transplanted cells linked up with existing cells to increase the contractility of the sphincter and thicken the urethra — a dual effect that increased urethra control, thus allowing the patient to regain continence.

"These are very intelligent cells," Dr. Frauscher said. "When they connect with other cells they stop growing." He said it takes about two weeks for the cells to complete the process. However, some women in the study reported a benefit within 24 hours of treatment. Dr. Frauscher said that was probably due to a "bulking" effect of the cells, creating pressure on the urethra.

Three of the women required a second injection, which Dr. Frauscher said was most likely due to scar tissue that formed during prior surgical procedures to try to correct incontinence. Of the two women who did not achieve complete relief of urinary incontinence, one did report improved symptoms. The procedure appeared to fail in the oldest recipient of the cells, an 84-year-old woman.

Previous attempts to use stem cells have failed, Dr. Frauscher said, because the cells were not placed correctly. "We need ultrasound to do this correctly. Without ultrasound we thought we were placing cells in the sphincter but we were not doing that," he said.

Michael Brant-Zawadski, MD, medical director of radiology at Hoag Memorial Hospital in Newport Beach, California, who moderated an RSNA press briefing on the study, called the results promising. He noted that if the results can be replicated, “the work shown here could result in life-changing improvement for millions of people with incontinence. When we reviewed the papers for this meeting we thought that this study was one of the most exciting presentations."

The stem cells were produced by InnovaCell. Dr. Frauscher disclosed that he is a consultant for the company, and two of his coauthors are co-owners of the company.

RSNA 90th Scientific Assembly and Annual Meeting: Abstract SSA06-01. Presented Nov. 28, 2004.

Reviewed by Gary D. Vogin, MD

 

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