USING women鈥檚 own stem cells to rebuild the muscles that control the bladder can cure incontinence.
鈥淪tress鈥� incontinence affects an estimated 10 to 35 per cent of women globally. The loss of control is due to shrinking of the muscles in the bladder sphincter and urethra wall, and happens as women age. In 1995, US sufferers alone spent $12.4 billion on drugs, incontinence pads and corrective surgery. The condition rarely afflicts men.
Christopher Woodhouse at the Institute of Urology and Nephrology, University College London, says existing treatments are often unsatisfactory. For example, collagen or liquid plastic injections to bulk up the urethra are not permanent and can make it difficult to pee. 鈥淚f you can make a muscle that relaxes and contracts in response to the body鈥檚 normal mechanisms, it would be a huge advance,鈥� he says.
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Ferdinand Frauscher and his colleagues at University Hospital, Innsbruck, Austria, wanted to see if stem cells could be used to do this. The team removed 4 cubic millimetres of muscle tissue from the biceps of 20 women aged 36 to 84. Stem cells from the tissue were then grown in culture for six weeks, producing 50 million myoblasts 鈥� the precursors of muscle fibres. This is a vital step, says Frauscher. 鈥淚f you want to get a strong sphincter muscle you must use a really large amount of cells.鈥�
The team injected the myoblasts into the urethra wall and sphincter of each woman. The extraction and injection procedures took about 15 minutes under local anaesthetic.
鈥淲ithin 24 hours 90 per cent of women treated had no urinary leakage. After two weeks muscle had increased significantly鈥�
Within 24 hours, 90 per cent of the women had no urinary leakage. And after two weeks muscle tissue had increased significantly and bladder contractions were visible on ultrasound scans when they hadn鈥檛 been before. More than a year later, 18 of the 20 women have maintained full bladder control, says Frauscher, who presented the results at the Radiological Society of North America meeting in Chicago last week. The team is treating nine women per week, and the waiting list is growing.