In a major breakthrough, researchers in Austria have developed an ultrasound-guided technique to repair the urinary tract of patients with urinary incontinence by injecting stem cells harvested from the patient's own body. They found that almost every patient had been cured one year after the stem cell treatment.
Ultrasound-guided stem cell injection has the potential to become a minimally invasive, cost-effective, and revolutionary treatment option for urinary incontinence. It can be performed as an outpatient procedure in 15 minutes with local anesthesia and can easily be done again if necessary. Current surgical options are costly in dollars and time, and they do not have long-lasting effects. Collagen(Drug information on collagen) injections also have limited effect. Use of adult diapers as a long-term solution is not only costly but socially embarrassing, lead author Dr. Ferdinand Frauscher, a radiologist at the Medical University of Innsbruck, said at the RSNA meeting.
The social implications of urinary incontinence tend to overshadow more prominent economic factors, Frauscher said. Incontinence affects about 30% of people 60 years and older, which means more than one billion people will have the condition by 2030. Although it afflicts mostly women, it is becoming a concern for an increasing number of men.
In 2002, Frauscher and colleagues enrolled 20 female patients aged 36 to 84 with urinary stress incontinence. They underwent left arm biopsies designed to obtain autologous myoblasts and fibroblasts that were then cultured in a lab for six weeks.
Using ultrasound guidance, the researchers injected the stem cells into the patients' urethral wall and sphincter muscles. Transurethral ultrasound showed a substantially increased thickness of the urethra and the rhabdosphincter (p<0.001), with a significant improvement in muscle contractility and quality of life after therapy.
The same investigative team evaluated the viability of color Doppler ultrasound to assess urethral function, using an endoluminal probe. They enrolled 10 healthy and 10 incontinent women as well as 10 female patients
who had undergone incontinence surgery. The investigators confirmed a sliding movement from the distal to the proximal urethra in addition to the known constrictive ability of the female sphincter. This may be useful in evaluating both continent and incontinent subjects, Frauscher said.
