Urinary incontinence (UI) is the involuntary loss of urine and is a common condition in middle-aged and elderly women and men.
Stress urinary incontinence (SUI) is caused by leakage of urine when coughing, sneezing, laughing, lifting, exercise or even standing leads to increased intraabdominal pressure. Other types of UI also exist such as urge incontinence (also called overactive bladder), which is a strong and unexpected sudden urge to urinate, mixed forms of UI that result in symptoms of both urge and stress incontinence and functional incontinence caused by reduced mobility, cognitive impairment or neuromuscular limitations that impair mobility or dexterity. However for many SUI patients there is significant loss of urethral sphincter muscle due to degeneration of tissue, the strain and trauma of pregnancy and childbirth or injury acquired during surgery. Hence, for individuals with SUI a cell-based therapeutic approach to regenerate the sphincter muscle offers the advantage of treating the cause rather than the symptoms. We discuss current clinically relevant cell therapy approaches for regeneration of the external urethral sphincter (striated muscle), internal urethral sphincter (smooth muscle), the neuromuscular synapse and blood supply. The use of mesenchymal stromal/stem cells (MSC) are a major step in the right direction, but they may not be enough for regeneration of all components of the urethral sphincter. Inclusion of other cell types or biomaterials may also be necessary to enhance integration and survival of the transplanted cells.
Written by:
Hart ML, Izeta A, Herrera-Imbroda B, Amend B, Brinchmann JE. Are you the author?
University of Tübingen, Clinical Research Group KFO 273, Department of Urology, Paul-Ehrlich-Str. 15, Tübingen, Germany, 72074.
Reference: Tissue Eng Part B Rev. 2015 Mar 19. Epub ahead of print.
doi: 10.1089/ten.TEB.2014.0627
PubMed Abstract
PMID: 25789845