Chulalongkorn Medical Journal


Background : Stress urinary incontinence (SUI) is uncontrolable leakage ofurine, induced by physical activities such as coughing andlaughing. The prevalence of SUI is going to increase. In addition,the quality of life in those patients is much lower than that ofnormal people.Objectives : To determine the effect of autologous stem cell therapy in femaleSUI. This review assesses clinical outcome of autologous stemcell therapy compared with other techniques.Design : Retrospective study.Materials and Methods : Selection criteria: all randomized controlled trials and clinicalcontrolled-trials that compared effectiveness between injectionsof autologous stem cells and conventional treatments in womenwith SUI. The outcomes were clinical improvement of urinaryincontinence and complications after intervention.Search strategy : MEDLINE, Cochrane Library, and Scopus were searchedmonthly 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 availablefor 63 women with SUI. After 1-year follow up, the medianincontinence score of patients treated with autologous cellssignificantly decreased compared with patients treated withcollagen (p value <0.0001, RRR = 0.895, NNT = 1.235).The rhabdosphincter in patients treated with autologous cellswas thicker and more improved in contractility than patientstreated with the standard treatment (p value <0.0001).The thickness of urethra was not significantly different betweenthe two groups (p value = 0.366). The quality of life score andelectromyography activity, both at rest and during voluntarycontraction of the rhabdosphincter muscles, significantly changedin patients treated with autologous cells than those given collagentherapy (p value <0.0001). The treatment with transurethralultrasonography-guided injections of autologous myoblasts andfibroblasts in women with SUI is significantly more effective thantreatment with standard endoscopic injections of collagen.All patients did not have any complication.Conclusion : The evidence from this review suggested that at present stemcell therapy for SUI should not be applied as a standardtreatment. Further randomized controlled trials are needed tobe done before make definite conclusion.


Faculty of Medicine, Chulalongkorn University

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