Autologous Muscle Derived Cell Therapy for Stress Urinary Incontinence: A Prospective, Dose Ranging Study

Carr, Lesley K.; Robert, Magali; Kultgen, Patricia L.; Herschorn, Sender; Birch, Colin; Murphy, Magnus; Chancellor, Michael B.

doi:10.1016/j.juro.2012.09.028

Cited by 113 publications

(99 citation statements)

References 18 publications

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“…However, the efficacy results differ widely, as the methodology used for studies was very different, as described below. All studies were phase II prospective observational studies, except for 2 randomized studies [1,2], in which patients were randomized to different doses of stem cells.…”

Section: Resultsmentioning

confidence: 99%

Current Controversies in Stem-Cell Treatment of Urinary Incontinence in Women

Ferrer¹,

Machado-Linde²,

Prieto-Sánchez³

et al. 2014

Int J Gynecol Clin Pract

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Background: Urinary incontinence (UI) is a major cause of morbidity in the world and is believed to affect up to 46% of the female population Our objective was to analyze the papers that describe stem-cell treatments for UI in women. Methods: We performed a systematic review of the literature from 1946 to date that reports on clinical trials that use stem cells to treat women with urinary incontinence. Results: Nine articles (7 observational and 2 randomized studies) met the inclusion criteria. No major adverse effects were observed in any of the studies. However, the efficacy results differ widely, as the methodology used for studies was very different, as described below. Conclusion: Stem-cell therapy is promising but still experimental, and further study is needed to identify certain factors. These facts include the ideal type of patient eligible for treatment (apparently those in whom intrinsic urethral dysfunction predominates), and to determine if treatment should be isolated or combined with other cells or procedures, which are the optimal doses and if it is a cost effective procedure.

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Section: Resultsmentioning

confidence: 99%

Current Controversies in Stem-Cell Treatment of Urinary Incontinence in Women

Ferrer¹,

Machado-Linde²,

Prieto-Sánchez³

et al. 2014

Int J Gynecol Clin Pract

View full text Add to dashboard Cite

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“…A pooled mean was calculated from all three resulting in an estimated base case cure rate of 68%. Although there are other studies in the literature showing similar efficiency for IVM, they were not included here due to lack of definition the 'cured' patient population [34,35]. All patients not included in the group of 'cured' were added to the group 'not cured', despite having shown improvements.…”

Section: Probabilitiesmentioning

confidence: 99%

Cell-based Therapy for the Treatment of Female Stress Urinary Incontinence: An Early Cost–Effectiveness Analysis

et al. 2018

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Aim:To perform an early cost-effectiveness analysis of in vitro expanded myoblasts (IVM) and minced myofibers versus midurethral slings (MUS) for surgical treatment of female stress urinary incontinence. Methods: Cost-effectiveness and sensitivity analyses were performed using a decision tree comprising previously published data and expert opinions. Results & conclusion: In the base case scenario, MUS was the cost-effective strategy with a negative incremental cost-effectiveness ratio compared with IVM and a positive incremental cost-effectiveness ratio compared with minced myofibers. However, the sensitivity analysis indicates that IVM may become an alternative providing greater effect at a higher cost. With the possibility of becoming more effective, IVM treatment would be advantageous over MUS given its reduced invasiveness and lower risks of complications. Urinary incontinence (UI) is a common medical condition that has a negative impact on the quality of life of individuals of all ages, racial and ethnic groups. The prevalence of UI is about two-to-four-times higher in women than in men, ranging from 11 to 57% [1]. The most common subtype is stress urinary incontinence (SUI), affecting roughly 50% of any women with UI [2]. SUI describes a condition where there is an involuntary leak of urine when intra-abdominal pressure rises, for example, when coughing, sneezing, laughing or during other physical activity. SUI has not only a severe impact on quality of life but it also places a substantial economic burden on the healthcare system and society [3][4][5]. In the USA, for example, it has been estimated that in 1998, the average direct medical cost of SUI amounted US$5642 per patient, while the indirect workplace expenses were US$4208 [3]. Evidence suggests that these costs have experienced an age-related increase over the last years [5].The clinical management of SUI is complex and may involve conservative treatments, such as pelvic floor muscle training and pharmacotherapy, as well as surgical procedures. Currently, the gold standard for surgical management of SUI in women is the midurethral sling (MUS), which displays a cure rate of 80-95% [6][7][8]. While MUS has a high success rate, 5-20% of the patients will have persisting incontinence thus needing to undergo sling removal and subsequent treatment [9]. The postoperative complications reach as high as 7.2% for erosion and the risk of getting a perioperative urinary tract infection is 17.2% [10]. As an alternative to MUS implantation, with the goal of targeting the underlying etiology rather than relieving the symptoms, cell-based therapies (CBTs) have recently emerged [11]. Among the different modalities of CBT, intraurethral injection of autologous skeletal myoblasts appears as one of the most promising regenerative therapies for SUI [12]. While various large-scale clinical trials are still ongoing, results from the initial clinical studies have shown that these approaches appear to be safe and moderately effective. Remarkably, a recent study has shown ...

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“…94 Their potentiality to restore function vias direct effects on the underlying mechanisms leading to incontinence or voiding dysfunction has been evaluated in preclinical animal models and clinical trials, especially for SUI. [95][96][97] Mesenchymal Stem Cells (MSCs), Muscle-Derived Stem Cells (MDSCs), Adipose-Derived Stem Cells (ADSCs) and Urine-Derived Stem Cells (USCs) are the sources of stem cells investigated for therapeutic benefit in urologic applications. 95,[97][98][99] Clinical trials reported improvement in SUI, through great reduction in pad weight, diaryreported leaks and even a complete achievement of continence in women, with no serious adverse events (pain, bruising at biopsy or injection sites).…”

Section: Research In Incontinencementioning

confidence: 99%

“…[95][96][97] Mesenchymal Stem Cells (MSCs), Muscle-Derived Stem Cells (MDSCs), Adipose-Derived Stem Cells (ADSCs) and Urine-Derived Stem Cells (USCs) are the sources of stem cells investigated for therapeutic benefit in urologic applications. 95,[97][98][99] Clinical trials reported improvement in SUI, through great reduction in pad weight, diaryreported leaks and even a complete achievement of continence in women, with no serious adverse events (pain, bruising at biopsy or injection sites). 95 To date, stem cells have shown promising results for the treatment of voiding dysfunction.…”

Section: Research In Incontinencementioning

confidence: 99%

“…95,[97][98][99] Clinical trials reported improvement in SUI, through great reduction in pad weight, diaryreported leaks and even a complete achievement of continence in women, with no serious adverse events (pain, bruising at biopsy or injection sites). 95 To date, stem cells have shown promising results for the treatment of voiding dysfunction. Applications in SUI and OAB have demonstrated success in both preclinical animal trials and limited clinical trials.…”

Section: Research In Incontinencementioning

confidence: 99%

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