Various bulking agents have been used since long for SUI treatment. Their low immediate and long term success rate associated with complications like particle migration, inflammatory reaction and urinary retention have made them not very popular for the clinical use. Lately, Incontinence researchers have been focusing on regenerative repair of damaged sphincter with stem cells. Muscle -derived stem cells (MDSC) and adipose- derived stem cells (ADSC) may become the future bulking agents for urinary incontinence treatment. They persist longer at the implanted site, cause less urinary retention and also improve the function of urethral sphincter.
A pilot study (Stem Cells Transl Med. 2014 Jul 1. pii: sctm.2013-0197) was recently conducted to find out whether transurethral injections (via cystoscope) of autologous adipose stem cells (ASCs) are an effective and a safe treatment for SUI. Five SUI patients were treated with ASCs combined with bovine collagen gel and saline. ASCs were isolated from subcutaneous fat and expanded for 3 weeks in laboratory. At 1 year, the cough test was negative in 3 patients. Validated questionnaires showed some subjective improvement in all five patients. In this small study, autologous adipose stem cells seems to be safe and well tolerated but larger studies are needed specially to know more about feasibility, safety and efficacy.
I am interested to see more and more trials coming out with stem cell therapy for SUI because they are unique for regenerating the sphincter, improved long term success rate and low surgical risk.