Highlights in the minimally invasive treatment of SUI in women

Objective: Treatment of stress urinary incontinence consists of a wide range of options, from conservative therapies like lifestyle changes, medication, pelvic floor muscles exercises, electro-stimulation, to minimally invasive procedures- injection of collagen, suburethral slings TVT / TOT and last but not least, invasive surgical treatment reserved for recurrent and complex cases. Among the latest minimally invasive procedures reported in literature, the injection of intra-and perisphincterian of autologous stem cell (mioblasts and /or mature fibroblasts grown and multiplied in the laboratory from biopsy samples taken from the pectoralis muscles). Material and method: On October 18, 2010, in ‘Fundeni’ Clinical Institute of Uronephrology and Renal Transplantation was performed the first stem cell implantation procedure in the urethral sphincter, in Romania. Results: Assessment at 6 weeks, the quality of life questionnaires, micturition diary and clinical examination revealed a stunning decrease of urine loss from 6 pads / day at one per day, which significantly improved the patient's quality of life. Conclusions: Stem–cell–mioblasts therapy may represent in the future an every–day intervention in the urologist's armamentarium. The effectiveness of this treatment can change the course of therapy and last but not least, the accessibility to urological evaluation of patients with stress urinary incontinence. Clinical and urodynamic evaluations will continue and will be future scientific topics

[1]  J. Lang,et al.  Role of different childbirth strategies on pelvic organ prolapse and stress urinary incontinence: a prospective study. , 2008, Chinese medical journal.

[2]  F. Daneshgari,et al.  Advancing the understanding of pathophysiological rationale for the treatment of stress urinary incontinence in women: the ‘trampoline theory’ , 2006, BJU international.

[3]  J. Barrington,et al.  Pelvicol pubovaginal sling versus tension-free vaginal tape for treatment of urodynamic stress incontinence: a prospective randomized three-year follow-up study. , 2004, European urology.

[4]  G. Bartsch,et al.  Stem cell therapy for urinary stress incontinence , 2004, Experimental Gerontology.

[5]  S. Straus,et al.  Management of urinary incontinence in women: scientific review. , 2004 .

[6]  A. Herzog,et al.  Proceedings of the National Institute of Diabetes and Digestive and Kidney Diseases International Symposium on Epidemiologic Issues in Urinary Incontinence in Women. , 2003, American journal of obstetrics and gynecology.

[7]  Magnus Fall,et al.  The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. , 2003, Urology.

[8]  G. Bartsch,et al.  Anatomic and functional studies of the male and female urethral sphincter , 2000, World Journal of Urology.

[9]  M. Steinlechner,et al.  Urinary incontinence in the elderly and age-dependent apoptosis of rhabdosphincter cells , 1999, The Lancet.

[10]  S. Meyer,et al.  The Effects of Birth on Urinary Continence Mechanisms and Other Pelvic‐Floor Characteristics , 1998, Obstetrics and gynecology.

[11]  J. Ashton-Miller,et al.  Effect of Pelvic Muscle Exercise on Transient Incontinence During Pregnancy and After Birth , 1998, Obstetrics and gynecology.

[12]  S. K. Van Den Eeden,et al.  Evaluation of Parturition and Other Reproductive Variables as Risk Factors for Urinary Incontinence in Later Life , 1997, Obstetrics and gynecology.

[13]  G. Schaer,et al.  Changes in Vesical Neck Mobility Following Vaginal Delivery , 1996, Obstetrics and Gynecology.

[14]  N. Baumann.  Urinary incontinence. , 2013, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[15]  Smith,et al.  Surgical Treatment of Incontinence in Women , 2002 .