Transurethral injection of autologous adipose-derived stem cells for urinary incontinence after radical prostatectomy

doi:10.3969/j.issn.2095-4344.0441

Abstract

Abstract:

BACKGROUND: Until now, there are no reliable methods for the treatment of urinary incontinence after radical prostatectomy. Some limitations exist in drug therapy, mid-urethral suspension, and filling agent treatment. Therefore, the use of autologous adipose-derived stem cells (ADSCs) is expected to become a first-line treatment strategy for urinary incontinence after radical prostatectomy.
OBJECTIVE: To report our initial experience with transurethral injection of autologous ADSCs for the treatment of urinary incontinence after radical prostatectomy.
METHODS: Patients and their families were informed of possible risks and benefits prior to the participation in the trial. After providing written informed consent, six patients with persistent urinary incontinence after radical prostatectomy were enrolled in the study. Under general anesthesia, about 50 mL of adipose tissue was obtained from each patient by liposuction. ADSCs were obtained by separation with centrifugation using the Celution cell-processing device. A mixture of ADSCs and adipose tissue was transurethrally injected into the submucosal space of the membranous urethra. Functional and anatomical improvement was assessed through a 24-hour pad test, validated patient questionnaire, urethral pressure profile, and magnetic resonance imaging (MRI) through 12-week follow-up.
RESULTS AND CONCLUSION: Urine leakage volume was improved with time in all patients in the 24-hour pad test, with the exemption of temporal deterioration in two patients at the first 2 weeks post-injection. Subjective symptoms and quality of life assessed on the basis of questionnaire results showed similar improvement. The mean maximum urethral closing pressure increased from 4.312 kPa to 6.223 kPa at 12 weeks after cell injection. MRI results showed an increase in functional profile length (from 6.1 to 8.3 mm) between the lower rim of the pubic bone and the bladder neck. Adverse events, such as pelvic pain, inflammation, or de novo urgency, were undetected in any case during the follow-up. To conclude, the transurethral injection of autologous ADSCs can be a safe and effective treatment for urinary incontinence after radical prostatectomy.

中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

Key words: Stem Cells, Adipose Tissue, Prostatic Neoplasms, Urinary Incontinence, Stem Cell Transplantation, Tissue Engineering

CLC Number:

R394.2

Mo Fei, Shen Hong-chun, Xu Ya-hong, Li Jian, Zhao Qi-hua, Luo Shun-wen, Lu Yi, Liu Yang, Jia Zhi-gang. Transurethral injection of autologous adipose-derived stem cells for urinary incontinence after radical prostatectomy[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(5): 717-722.

Figures/Tables 3

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