Advances in stem cell therapy for male stress urinary incontinence

ABSTRACT

Introduction: Among the several options that have been proposed in recent years for the management of male stress urinary incontinence (SUI), stem cell therapy represents a new frontier in treatment. The aim of this paper is to update the current status of stem cell therapy in animal and human studies for the management of iatrogenic male SUI.

Areas covered: A literature review was conducted based on MEDLINE/PubMed searches for English articles using a combination of the following keywords: stem cell therapy, urinary incontinence, prostatectomy, regenerative medicine, mesenchymal stem cells.

Expert opinion: The few studies reported in the literature have demonstrated short-term safety and promising results of stem cell therapy in treating male SUI. However, many aspects need to be clarified before stem cell therapy can be introduced into daily urologic practice. In fact, important issues such as the limitations of these studies in terms of small sample sizes and short follow-ups, the incomplete knowledge of the mechanism of action of stem cells, the technical details regarding the delivery method and the best sources of stem cells, the safety risks regarding genomic or epigenetic changes and potential immune reactions in the longer term need to be identified in more stringent clinical trials.

KEYWORDS:

• Adult stem cell
• cell therapy
• complication
• postoperative
• injections
• mesenchymal stem cells
• prostatectomy
• regenerative medicine
• urinary incontinence
• stress

Article highlights

• Stem cells therapy represents a new frontier for the management of male stress urinary incontinence.

• Adult stem cells (ASCs) are the only stem cell type that have been investigated for urologic applications.

• Local injections of ASCs have demonstrated efficacy in animal with improvement of anatomic and functional outcomes.

• Very few studies are reported in literature using ASCs for the treatment of SUI in male human patients but they showed short-term safety and promising results.

• Important issues such as the limitations of these studies, the incomplete knowledge of the mechanism of action, the best source and best delivery of stem cells, the safety risks regarding genomic or epigenetic changes and potential immune reactions in the long term need to be clarified.

• Further studies need to be conducted in order to clarify these crucial points. If these aspects are confirmed, stem cell therapy will probably be proposed as a treatment option for SUI in the future.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.