WebMD Medical News
Louise Chang, MD
May 21, 2007 -- For the more than 13 million women in the U.S. who suffer
from stress urinary incontinence, stem cells derived from their own muscle
cells may improve the condition, a study shows.
"Five of eight women got a modest degree of improvement, and one woman
was dry," says Michael Chancellor, MD, a urologist at the University of
Chancellor presented the results of a study at the 2007 annual meeting of
the American Urological Association in Anaheim, Calif.
At the same meeting, other researchers reported their efforts in obtaining
stem cells from the body's fat tissue, from urine, and from human cord blood to
treat urinary problems.
Stress incontinence is more common in women than in men. An involuntary loss
of urine occurs when a person coughs, sneezes, or laughs.
At the root of the problem is a weakened urethral sphincter, the muscles
that control the flow of urine. Childbirth and menopause both raise the risk of
women becoming incontinent.
Chancellor's research focuses on adult stem cells, a type of
undifferentiated cell found throughout the human body that can be extracted and
then coaxed in the laboratory into becoming different types of cells.
"For the past 10 years, we have been working on muscle-cell-derived stem
cells," Chancellor says. The process begins, he says, by taking a
small muscle biopsy, then isolating the stem cells. Next, they are grown in a
culture and then implanted back into the patient who supplied them to
strengthen the weakened sphincter.
"Our average follow-up was a year and a half," he says. "More
than half started reporting improvement after three months. Improvement kept
getting better for 10 months."
The average follow-up time, he says, was a year and a half. "This was
just a safety study," Chancellor says, noting that the study is
preliminary. The study was done in cooperation with the University of Toronto
and was a clinical trial approved by Health Canada.
Another treatment option is sorely needed, Chancellor says, for stress
urinary incontinence. Currently, doctors suggest women with the condition
perform pelvic floor exercises (Kegels) to strengthen the pelvic floor muscles,
biofeedback to retrain the muscles, or offer them surgery, if the condition is
severe or interferes with daily activities.
In one surgery, for instance, a mesh-like tape is inserted as a kind of
sling for the urethra, to support it and hold it in place so more normal
A woman's fat cells may provide another treatment option someday, says Tom
Lue, MD, a University of California San Francisco urologist. Using fat to
strengthen sphincter muscles is not new, he says. But using stem cells from fat
"As far back as 1994, a study was published talking about using fat
[injections] for sphincter incontinence," he says. "But using the fat
cells [themselves], they die. But using stem cells, they survive much
In his study of the concept in animals, his team harvested fat tissue,
processed it to retrieve the stem cells, and then injected it back into the
animals. A comparison group only got a buffered solution; the treatment group
received both the fat stem cells and the buffered solution.
He found that the stem cells became muscle tissue as well as blood vessel
and fat tissues. And by using a person's own stem cells, Lue says,
"we bypass immunology problems and ethical concerns."
While tissue biopsy is the most common way to obtain adult stem cells,
another researcher reported that he isolated them from human urine. Anthony
Atala, MD, a researcher at Wake Forest University in Winston-Salem, N.C., took
urine samples from nine men and isolated and expanded the cells. He implanted
them in mice and found they maintained their cellular characteristics. That
suggests urine may someday be a valuable additional source for stem cells to
help urinary problems.
Yet another research team is looking at human cord blood as a source of stem
cells that might help urinary incontinence. In a study done in South
Korea, Chester Koh, MD, a researcher at the University of Southern California,
Los Angeles, and his colleagues injected human cord blood stem cells into 39
women with stress urinary incontinence.
After one month, 80% of the women reported a 50% or greater improvement in
quality of life.
As promising as some of the research to help stress urinary incontinence
sounds, the studies are in "extremely early" stages, Roger Dmochowski,
MD, the moderator of the press briefing on tissue engineering, tells WebMD.
When might the new treatments be available? "At the earliest, three
years, more likely five to seven years," says Dmochowski, a urologist at
Vanderbilt University in Nashville, Tenn., and the president of the Society for
Female Urology and Urodynamics.
SOURCES: Roger Dmochowski, MD, urologist, Vanderbilt University, Nashville,
Tenn.; president, Society for Female Urology and Urodynamics. Michael
Chancellor, MD, urologist, University of Pittsburgh. Anthony Atala, MD,
urologist, Wake Forest University, Winston Salem, N.C. Tom Lue, MD, urologist,
University of California, San Francisco. Chester Koh, MD, urologist,
University of Southern California, Los Angeles.
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