Furuta Akira, Jankowski Ron J, Pruchnic Ryan, Yoshimura Naoki, Chancellor Michael B
Curr Urol Rep. 2007 Sep;8(5):373-8. doi: 10.1007/s11934-007-0034-4.
The promise of stem cell therapy for the treatment of stress urinary incontinence is that transplanted stem cells may undergo self-renewal and potential multipotent differentiation, leading to urethral sphincter regeneration. Cell-based therapies are most often associated with the use of autologous multipotent stem cells, such as bone marrow cells. However, harvesting bone marrow stromal stem cells is difficult, painful, and may yield low numbers of stem cells. Alternatively, autologous adult stem cells, such as muscle-derived stem cells, can be obtained in large quantities and with minimal discomfort. Not all cells and cellular therapies are the same, however, and proper placement of cells into target structures may be critical to eventual treatment success. In particular, restoration and repair of the damaged urethral sphincter is crucial to maintain urinary continence because active urethral closure is largely mediated by pudendal nerves that innervate the striated muscles and rhabdosphincter of the middle urethra.
干细胞疗法治疗压力性尿失禁的前景在于，移植的干细胞可能会进行自我更新并具有多能分化潜能，从而实现尿道括约肌再生。基于细胞的疗法通常与自体多能干细胞的使用相关，比如骨髓细胞。然而，采集骨髓基质干细胞困难、痛苦，且可能获得的干细胞数量较少。另外，自体成体干细胞，如肌肉衍生干细胞，可以大量获取且不适感最小。然而，并非所有细胞和细胞疗法都是一样的，将细胞正确植入目标结构对于最终治疗成功可能至关重要。特别是，受损尿道括约肌的修复对于维持尿失禁至关重要，因为主动尿道闭合主要由支配尿道中段横纹肌和横纹括约肌的阴部神经介导。
