Intraurethral Injection of Autologous Minced Skeletal Muscle: A Simple Surgical Treatment for Stress Urinary Incontinence

TY - JOUR

T1 - Intraurethral Injection of Autologous Minced Skeletal Muscle

T2 - A Simple Surgical Treatment for Stress Urinary Incontinence

AU - Gräs, Søren

AU - Klarskov, Niels

AU - Lose, Gunnar

N1 - Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

PY - 2014/9

Y1 - 2014/9

N2 - Purpose Intraurethral injection of in vitro expanded autologous skeletal muscle derived cells is a new regenerative therapy for stress urinary incontinence. We examined the efficacy and safety of a simpler alternative strategy using freshly harvested, minced autologous skeletal muscle tissue with its inherent content of regenerative cells. Materials and Methods A total of 20 and 15 women with uncomplicated and complicated stress urinary incontinence, respectively, received intraurethral injections of minced autologous skeletal muscle tissue and were followed for 1 year. Efficacy was assessed by the number of leakages in a 3-day diary and by ICIQ-SF scores. We calculated the rates of cure, defined as zero leaks in 3 days plus an ICIQ-SF score of 5 or less, and improvement, defined as simultaneous decreases in each outcome measure. Results Significant reductions were observed in each group in the mean number of leakages (p <0.01) and in ICIQ-SF scores (p <0.001). In the uncomplicated group cure and improvement were observed in 25% and 63% of patients, and in the complicated group they were noted in 7% and 57%, respectively. No voiding dysfunction developed and only minor adverse events were noted. Conclusions Intraurethral injection of minced autologous muscle tissue is a simple surgical procedure that appears safe and moderately effective in women with uncomplicated stress urinary incontinence. It compares well to a more complicated regenerative strategy using in vitro expanded muscle derived cells.

AB - Purpose Intraurethral injection of in vitro expanded autologous skeletal muscle derived cells is a new regenerative therapy for stress urinary incontinence. We examined the efficacy and safety of a simpler alternative strategy using freshly harvested, minced autologous skeletal muscle tissue with its inherent content of regenerative cells. Materials and Methods A total of 20 and 15 women with uncomplicated and complicated stress urinary incontinence, respectively, received intraurethral injections of minced autologous skeletal muscle tissue and were followed for 1 year. Efficacy was assessed by the number of leakages in a 3-day diary and by ICIQ-SF scores. We calculated the rates of cure, defined as zero leaks in 3 days plus an ICIQ-SF score of 5 or less, and improvement, defined as simultaneous decreases in each outcome measure. Results Significant reductions were observed in each group in the mean number of leakages (p <0.01) and in ICIQ-SF scores (p <0.001). In the uncomplicated group cure and improvement were observed in 25% and 63% of patients, and in the complicated group they were noted in 7% and 57%, respectively. No voiding dysfunction developed and only minor adverse events were noted. Conclusions Intraurethral injection of minced autologous muscle tissue is a simple surgical procedure that appears safe and moderately effective in women with uncomplicated stress urinary incontinence. It compares well to a more complicated regenerative strategy using in vitro expanded muscle derived cells.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Cell Transplantation

KW - Female

KW - Humans

KW - Injections

KW - Middle Aged

KW - Muscle, Skeletal

KW - Pilot Projects

KW - Regeneration

KW - Urethra

KW - Urinary Incontinence, Stress

KW - Urologic Surgical Procedures

U2 - 10.1016/j.juro.2014.04.005

DO - 10.1016/j.juro.2014.04.005

M3 - Journal article

C2 - 24735937

SN - 0022-5347

VL - 192

SP - 850

EP - 855

JO - The Journal of Urology

JF - The Journal of Urology

IS - 3

ER -