Li Pei-Chen, Ding Dah-Ching
Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan.
Institute of Medical Sciences, College of Medicine, Tzu Chi University, Hualien, Taiwan.
Tzu Chi Med J. 2022 Sep 5;35(2):111-119. doi: 10.4103/tcmj.tcmj_145_22. eCollection 2023 Apr-Jun.
The incidence of urinary incontinence (UI) is approximately 10%-40% in women, affecting one to two hundred million women worldwide. Stress UI (SUI) is characterized by involuntary urination due to increased abdominal stress and urine leakage without bladder contraction. Surgical treatments include midurethral slings, bulking agents, and Burch colposuspension to restore urethral continence. Nevertheless, an optimal treatment for all types of incontinence has not yet been established. Stem-cell therapy has emerged as a novel treatment for many diseases. Stem cells can self-renew and can differentiate into other cell types. Adult stem cells are suitable for clinical applications because they can be easily obtained noninvasively or minimal invasively. Stem-cell therapy for SUI has been studied preclinically and clinically. Muscle-derived progenitors have been used to treat SUI by promoting the regeneration of rhabdomyosphincters. The human trial used transurethral injection of autologous muscle-derived stem cells to improve sphincter contractility and function. Other sources of stem cells have also been studied in SUI treatment, such as umbilical cord blood, amniotic fluid, bone marrow, urine, and adipose tissue. The success rate of stem-cell therapy for SUI ranges from 13% to 100%. This review aimed to summarize the current status of stem-cell treatments for SUI, with respect to clinical trials, cell types, transplantation routes, and dosage volume and frequency.
女性尿失禁(UI)的发生率约为10%-40%,全球有1亿至2亿女性受其影响。压力性尿失禁(SUI)的特征是由于腹压增加导致不自主排尿,且尿液在无膀胱收缩的情况下漏出。手术治疗包括中段尿道吊带术、填充剂和Burch阴道悬吊术以恢复尿道控尿功能。然而,尚未确立针对所有类型尿失禁的最佳治疗方法。干细胞疗法已成为治疗多种疾病的新型疗法。干细胞能够自我更新,并可分化为其他细胞类型。成体干细胞适合临床应用,因为它们可以通过非侵入性或微创方式轻松获取。针对SUI的干细胞疗法已在临床前和临床进行了研究。肌肉来源的祖细胞已被用于通过促进横纹肌括约肌再生来治疗SUI。人体试验采用经尿道注射自体肌肉来源的干细胞来改善括约肌收缩力和功能。其他干细胞来源也已在SUI治疗中进行了研究,如脐带血、羊水、骨髓、尿液和脂肪组织。SUI干细胞疗法的成功率在13%至100%之间。本综述旨在总结SUI干细胞治疗的现状,涉及临床试验、细胞类型、移植途径以及剂量体积和频率。