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BMJ. 2007 July 7; 335(7609): 17.
PMCID: PMC1910651
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Treatment for stress incontinence passes initial trial

Urologists from Austria have developed a treatment for stress incontinence, which harnesses the regenerative potential of muscle cells to repair urethral damage. The cells are harvested from a biopsy of the patient's own skeletal muscle and cultured for about seven weeks to produce populations of myoblasts and fibroblasts. Surgeons inject the cells into the urethral sphincter (myoblasts) and submucosa (fibroblasts) under ultrasound guidance.

The autologous cells cured 38 out of 42 (90%) women in a preliminary randomised trial. The cure rate for controls given collagen injections was significantly lower, at 9.5% (2/21). Before treatment, the women in this small trial were severely incontinent, scoring the maximum score of 6 on a validated symptom scale for stress incontinence. Twelve months later, women treated with autologous cells had a median score of 0 (totally continent) while controls still had a median score of 6 (P<0.0001). The new treatment increased the thickness and contractility of the urethral sphincter, and improved patients' quality of life.

The trial could not be double blind, but the authors of an expert commentary (pp 2139-40 doi: 10.1016/S0140-6736(07)60990-8) think its emphatic results are unlikely to be because of bias. They and the authors of the study agree that bigger and better trials should be done to further explore this technique's potential. None of the women reported side effects.

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