Skip to main content

Advertisement

Log in

Muscle derived stem cell therapy for stress urinary incontinence

  • Topic Paper
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Aim

The aim of this article is to discuss the potential of muscle-derived stem cells (MDSCs) for rhabdosphincter regeneration and to review the early clinical experiences with its application in patients with stress urinary incontinence.

Results

In anatomical and functional studies of the human and animal urethra, the middle urethral contained rhabdosphincter is critical for maintaining continence. Transplanted stem cells have the ability to undergo self-renewal and multipotent differentiation, leading to sphincter regeneration. In addition, such cells may release, or be engineered to release, neurotrophins with subsequent paracrine recruitment of endogenous host cells to concomitantly promote a regenerative response of nerve-integrated muscle.

Conclusion

Cell-based therapies are most often associated with the use of autologous multipotent stem cells, such as bone marrow stromal cells. However, harvesting bone marrow stromal stem cells requires a general anesthetic, can be painful, and has variable yield of stem cells upon processing. In contrast, with appropriate experience, alternative autologous adult stem cells such as muscle-derived stem cells and adipose-derived stem cells can be obtained in large quantities and with minimal discomfort.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Hampel C, Wienhold D, Benken N, Eggersmann C, Thuroff JW (1997) Prevalence and natural history of female incontinence. Eur Urol 32(Suppl 2):3–12

    PubMed  Google Scholar 

  2. Meyer S, Schreyer A, De Grandi P, Hohlfeld P (1998) The effects of birth on urinary continence mechanisms and other pelvic-floor characteristics. Obstet Gynecol 92:613–618

    Article  PubMed  CAS  Google Scholar 

  3. Appell RA, Dmochowski RR, Herschorn S (2006) Urethral injections for female stress incontinence. BJU Int 98 (Suppl 1):27–30 (discussion 31)

    Article  PubMed  CAS  Google Scholar 

  4. Kiilholma PJ, Chancellor MB, Makinen J, Hirsch IH, Klemi PJ (1993) Complications of Teflon injection for stress urinary incontinence. Neurourol Urodyn 12:131–137

    Article  PubMed  CAS  Google Scholar 

  5. Schroder HD, Reske-Nielsen E (1983) Fiber types in the striated urethral and anal sphincters. Acta Neuropathol (Berl) 60:278–282

    Article  CAS  Google Scholar 

  6. de Groat WC (2006) Integrative control of the lower urinary tract: preclinical perspective. Br J Pharmacol 147(Suppl 2):S25–S40

    Article  PubMed  Google Scholar 

  7. Strasser H, Ninkovic M, Hess M, Bartsch G, Stenzl A (2000) Anatomic and functional studies of the male and female urethral sphincter. World J Urol 18:324–329

    Article  PubMed  CAS  Google Scholar 

  8. Strasser H, Tiefenthaler M, Steinlechner M, Eder I, Bartsch G, Konwalinka G (2000) Age dependent apoptosis and loss of rhabdosphincter cells. J Urol 164:1781–1785

    Article  PubMed  CAS  Google Scholar 

  9. Pittenger MF, Mackay AM, Beck SC, Jaiswal RK, Douglas R, Mosca JD, Moorman MA, Simonetti DW, Craig S, Marshak DR (1999) Multilineage potential of adult human mesenchymal stem cells. Science 284:143–147

    Article  PubMed  CAS  Google Scholar 

  10. Qu Z, Balkir L, van Deutekom JC, Robbins PD, Pruchnic R, Huard J (1998) Development of approaches to improve cell survival in myoblast transfer therapy. J Cell Biol 142:1257–1267

    Article  PubMed  CAS  Google Scholar 

  11. Collins CA, Olsen I, Zammit PS, Heslop L, Petrie A, Partridge TA, Morgan JE (2005) Stem cell function, self-renewal, and behavioral heterogeneity of cells from the adult muscle satellite cell niche. Cell 122:289–301

    Article  PubMed  CAS  Google Scholar 

  12. Lecoeur C, Swieb S, Zini L, Riviere C, Combrisson H, Gherardi R, Abbou C, Yiou R (2007) Intraurethral transfer of satellite cells by myofiber implants results in the formation of innervated myotubes exerting tonic contractions. J Urol 178:332–337

    Article  PubMed  Google Scholar 

  13. Jankowski RJ, Deasy BM, Huard J (2002) Muscle-derived stem cells. Gene Ther 9:642–647

    Article  PubMed  CAS  Google Scholar 

  14. Oshima H, Payne TR, Urish KL, Sakai T, Ling Y, Gharaibeh B, Tobita K, Keller BB, Cummins JH, Huard J (2005) Differential myocardial infarct repair with muscle stem cells compared to myoblasts. Mol Ther 12:1130–1141

    Article  PubMed  CAS  Google Scholar 

  15. Lee JY, Qu-Petersen Z, Cao B, Kimura S, Jankowski R, Cummins J, Usas A, Gates C, Robbins P, Wernig A et al (2000) Clonal isolation of muscle-derived cells capable of enhancing muscle regeneration and bone healing. J Cell Biol 150:1085–1100

    Article  PubMed  CAS  Google Scholar 

  16. Qu-Petersen Z, Deasy B, Jankowski R, Ikezawa M, Cummins J, Pruchnic R, Mytinger J, Cao B, Gates C, Wernig A et al (2002) Identification of a novel population of muscle stem cells in mice: potential for muscle regeneration. J Cell Biol 157:851–864

    Article  PubMed  CAS  Google Scholar 

  17. Yokoyama T, Yoshimura N, Dhir R, Qu Z, Fraser MO, Kumon H, de Groat WC, Huard J, Chancellor MB (2001) Persistence and survival of autologous muscle derived cells versus bovine collagen as potential treatment of stress urinary incontinence. J Urol 165:271–276

    Article  PubMed  CAS  Google Scholar 

  18. Kwon D, Kim Y, Pruchnic R, Jankowski R, Usiene I, de Miguel F, Huard J, Chancellor MB (2006) Periurethral cellular injection: comparison of muscle-derived progenitor cells and fibroblasts with regard to efficacy and tissue contractility in an animal model of stress urinary incontinence. Urology 68:449–454

    Article  PubMed  Google Scholar 

  19. Chancellor MB, Yokoyama T, Tirney S, Mattes CE, Ozawa H, Yoshimura N, de Groat WC, Huard J (2000) Preliminary results of myoblast injection into the urethra and bladder wall: a possible method for the treatment of stress urinary incontinence and impaired detrusor contractility. Neurourol Urodyn 19:279–287

    Article  PubMed  CAS  Google Scholar 

  20. Yokoyama T, Pruchnic R, Lee JY, Chuang YC, Jumon H, Yoshimura N, de Groat WC, Huard J, Chancellor MB (2001) Autologous primary muscle-derived cells transfer into the lower urinary tract. Tissue Eng 7:395–404

    Article  PubMed  CAS  Google Scholar 

  21. Lee JY, Cannon TW, Pruchnic R, Fraser MO, Huard J, Chancellor MB (2003) The effects of periurethral muscle-derived stem cell injection on leak point pressure in a rat model of stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 14:31–37 (discussion 37)

    Article  PubMed  CAS  Google Scholar 

  22. Chermansky CJ, Tarin T, Kwon DD, Jankowski RJ, Cannon TW, de Groat WC, Huard J, Chancellor MB (2004) Intraurethral muscle-derived cell injections increase leak point pressure in a rat model of intrinsic sphincter deficiency. Urology 63:780–785

    Article  PubMed  Google Scholar 

  23. Zeng X, Jack GS, Zhang R et al (2006) Treatment of SUI using adipose derived stem cells: Restoration of urethral function. J Urol 175:291 (abstract)

    Google Scholar 

  24. Florini JR, Ewton DZ, Magri KA (1991) Hormones, growth factors, and myogenic differentiation. Annu Rev Physiol 53:201–216

    Article  PubMed  CAS  Google Scholar 

  25. Rende M, Brizi E, Conner J, Treves S, Censier K, Provenzano C, Taglialatela G, Sanna PP, Donato R (2000) Nerve growth factor (NGF) influences differentiation and proliferation of myogenic cells in vitro via TrKA. Int J Dev Neurosci 18:869–885

    Article  PubMed  CAS  Google Scholar 

  26. Dedkov EI, Kostrominova TY, Borisov AB, Carlson BM (2002) Survival of Schwann cells in chronically denervated skeletal muscles. Acta Neuropathol (Berl) 103:565–574

    Article  CAS  Google Scholar 

  27. Furuta A, Jankowski RJ, Honda M, Pruchnic R, Yoshimura N, Chancellor MB (2007) State of the art of where we are at using stem cells for stress urinary incontinence. Neurourol Urodyn 26:966–971

    Article  PubMed  Google Scholar 

  28. Strasser H, Marksteiner R, Margreiter E, Mitterberger M, Pinggera GM, Frauscher F, Fussenegger M, Kofler K, Bartsch G (2007) Transurethral ultrasonography-guided injection of adult autologous stem cells versus transurethral endoscopic injection of collagen in treatment of urinary incontinence. World J Urol 25:385–392

    Article  PubMed  CAS  Google Scholar 

  29. Strasser H, Pinggera GM, Gozzi C, Horninger W, Mitterberger M, Frauscher F, Bartsch G (2004) Three-dimensional transrectal ultrasound of the male urethral rhabdosphincter. World J Urol 22:335–338

    Article  PubMed  CAS  Google Scholar 

  30. Strasser H, Marksteiner R, Margreiter E, Pinggera GM, Mitterberger M, Frauscher F, Ulmer H, Fussenegger M, Kofler K, Bartsch G (2007) Autologous myoblasts and fibroblasts versus collagen for treatment of stress urinary incontinence in women: a randomized controlled trial. Lancet 369:2179–2186

    Article  PubMed  CAS  Google Scholar 

  31. Mitterberger M, Pinggera GM, Marksteiner R, Margreiter E, Fussenegger M, Frauscher F, Ulmer H, Hering S, Bartsch G, Strasser H (2007) Adult stem cell therapy of female stress urinary incontinence. Eur Urol 53:169–175

    Article  PubMed  Google Scholar 

  32. Carr LK, Steele D, Steele S, Wagner D, Pruchnic R, Jankowski R, Erickson J, Huard J, Chancellor MB (2008) 1-year follow-up of autologous muscle-derived stem cell injection pilot study to treat stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19(6):881–883

    Article  Google Scholar 

Download references

Conflict of interest statement

There is no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Marc C. Smaldone.

Additional information

M. B. Chancellor is a consultant to Cook and has received research grants from Cook. Our SUI research has been supported by National Institutes of Health grants (DK67226, AR49398, and DK55387) and Cook MyoSite funding.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Smaldone, M.C., Chancellor, M.B. Muscle derived stem cell therapy for stress urinary incontinence. World J Urol 26, 327–332 (2008). https://doi.org/10.1007/s00345-008-0269-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-008-0269-9

Keywords

Navigation