This is a joint study from Iran and University College London. Stress urinary incontinence (SUI) is a difficult condition to treat for patients and clinicians alike. Various surgical procedures have their benefits and pitfalls. Cell therapy is a new modality; 120mls of peripheral blood is taken and total nucleated cells (TNC) and platelets were prepared. After final centrifugation the total volume of TNC and platelets mixture (TNC-P-M) was 10mls. Transurethral endoscopic injection of TNC-P-M was carried out under general anaesthesia. A 21F rigid cystoscope was used and puncture needle of size 18G was passed. Then 8ml mixture was injected at Rhabdo sphincter while 2ml was injected at 3 and 9 o’clock in the submucosal space to provide bulking effect. This cell therapy was tried in nine patients. No morbidity was seen during and after injection. None of the patients had voiding dysfunction, retention or urinary tract infection. Patients were followed up at one, three and six months. Eight patients were completely dry while one patient had marked improvement. This pilot study shows that treatment of SUI with TNC-P is safe and effective. Intrinsic sphincter deficiency (ISD) is related to the weakening of the urethral sphincter muscle. This is due to cellular ageing, cell death (apoptosis) and necrosis as we grow old. Stem celll therapy offers a potential cure for difficult SUI cases. 

A novel cell therapy for stress urinary incontinence – short-term outcome.
Shirvan MK, Alamdari DH, Mahboub MD, et al.
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Arun K Sharma

West Herts NHS Trust (Watford General Hospital)

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