Successful treatment of female SUI with autologous myoblast and fibroblast injection
Original article
Mitterberger M et al. (2007) Autologous myoblasts and fibroblasts for female stress incontinence: a 1-year follow-up in 123 patients. BJU Int 100: 1081–1085 PubMed
In female stress urinary incontinence (SUI), resting tone and contractibility of the rhabdosphincter are reduced, leading to incomplete closure of the urethra. Mitterberger and co-workers have evaluated the therapeutic potential of autologous myoblasts and fibroblasts, which have previously shown efficacy in animal models of SUI, for the regeneration of the rhabdosphincter and urethral submocosa.
In total, 119 patients with SUI and no more than mild hypermobility of the urethra and bladder completed 1 year of follow-up. Autologous myoblasts and fibroblasts were grown from biopsy samples of biceps muscle, and transurethral ultrasonography was used to guide their injection into the rhabdosphincter (myoblast suspension) and the urethral submucosa (fibroblast–collagen suspension). No complications were associated with the implantation procedure and no severe adverse effects were reported during the follow-up period.
At 1 year, 94 (79%) of the 119 patients were completely continent. The remaining patients showed substantial (13%) or slight (8%) improvement of continence; no deterioration of incontinence was observed. Compared with pretreatment measurements, improvements were seen at 1 year in Incontinence Score and Incontinence Quality of Life score, and also in the thickness, contractibility and electromyographic activity of the rhabdosphincter, representing clinical improvement in sphincter function. The improvements could not be attributed to a simple 'bulking effect' of the injections.
The investigators conclude that transurethral-ultrasonography-guided injection of autologous myoblasts and fibroblasts is a safe and effective treatment for female SUI, and that long-term multicenter replication of their data is warranted.
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Subject areas under which this article appears: Urinary incontinence, urodynamics and lower urinary tract dysfunction | Female urology