A systematic review of autologous stem cell therapy in female stress urinary incontinence

Abstract

Background : Stress urinary incontinence (SUI) is uncontrolable leakage of urine, induced by physical activities such as coughing and laughing. The prevalence of SUI is going to increase. In addition, the quality of life in those patients is much lower than that of normal people.

Objectives : To determine the effect of autologous stem cell therapy in female SUI. This review assesses clinical outcome of autologous stem cell therapy compared with other techniques.

Design : Retrospective study.

Materials and Methods : Selection criteria: all randomized controlled trials and clinical controlled-trials that compared effectiveness between injections of autologous stem cells and conventional treatments in women with SUI. The outcomes were clinical improvement of urinary incontinence and complications after intervention.

Search strategy : MEDLINE, Cochrane Library, and Scopus were searched monthly from June to September 2008.

Methods of the review : All review authors assessed the trials for methodological quality.

Results : There was only one randomized control trial with data available for 63 women with SUI. After 1-year follow up, the median incontinence score of patients treated with autologous cells significantly decreased compared with patients treated with collagen (p value <0.0001, RRR = 0.895, NNT = 1.235). The rhabdosphincter in patients treated with autologous cells was thicker and more improved in contractility than patients treated with the standard treatment (p value <0.0001). The thickness of urethra was not significantly different between the two groups (p value = 0.366). The quality of life score and electromyography activity, both at rest and during voluntary contraction of the rhabdosphincter muscles, significantly changed in patients treated with autologous cells than those given collagen therapy (p value <0.0001). The treatment with transurethral ultrasonography-guided injections of autologous myoblasts and fibroblasts in women with SUI is significantly more effective than treatment with standard endoscopic injections of collagen. All patients did not have any complication.

Conclusion : The evidence from this review suggested that at present stem cell therapy for SUI should not be applied as a standard treatment. Further randomized controlled trials are needed to be done before make definite conclusion.