Adult stem cell therapy for female stress urinary incontinence — simplified summary

Authors: Michael Mitterberger et al. Journal: European Urology. 2008 Jan;53(1):169–175. PMID: 17683852 · DOI: 10.1016/j.eururo.2007.07.026

This clinical study tested whether a patient’s own muscle-derived cells (adult stem/progenitor cells) could be used to treat stress urinary incontinence (SUI) in women. SUI is leaking of urine during coughing, sneezing, or physical activities caused by weakness of the pelvic floor and urethral sphincter muscles.

• 20 women with stress urinary incontinence
• Treated between January and June 2005
• Followed for up to 2 years after the procedure

• A small skeletal muscle biopsy (from the left arm) was taken from each woman.
• From that tissue, two types of cells were grown in the lab:
• Myoblasts — immature muscle cells that can help rebuild muscle.
• Fibroblasts — connective tissue cells that help provide structure and support.
• Using transurethral ultrasound (TUUS) to guide placement, the team injected:
• Fibroblasts into the urethral submucosa (the tissue layer under the lining of the urethra).
• Myoblasts into the rhabdosphincter (the striated muscle that controls continence).
• Patients were evaluated before treatment and at intervals up to 2 years using:
• Incontinence scores and quality-of-life questionnaires
• Urodynamic tests (how the bladder and urethra work)
• Electromyography (EMG) to measure muscle activity
• Ultrasound to check thickness/structure of the urethra and sphincter

• At 1 year after treatment:
• 18 of 20 patients were considered cured of SUI.
• The other 2 patients showed improvement.
• At 2 years:
• 16 of the original 18 remained cured.
• 2 were improved.
• 2 patients were lost to follow-up (no data available).
• Objective tissue/function changes after therapy:
• Increased thickness of urethra and rhabdosphincter.
• Increased activity and contractility of the rhabdosphincter (measured by EMG/urodynamics).
• Patient-reported incontinence scores and quality-of-life measures improved significantly.

• Using a person’s own muscle-derived cells (autologous myoblasts and fibroblasts) injected into the urethra and sphincter showed promising results for improving or curing stress urinary incontinence in this small study.
• The injections appeared to both add tissue bulk (structural support) and improve muscle function (better contraction), which together likely reduced leakage.
• The technique is minimally invasive compared with major surgery and uses the patient’s own cells, which reduces the risk of immune rejection.

• Autologous cell therapies: This study is an example of an effective autologous (self-derived) regenerative therapy — using your own cells reduces rejection risk and can restore tissue function.
• Role of cell type: Combining muscle progenitor cells (myoblasts) with supportive connective tissue cells (fibroblasts) can rebuild both structure and function. That’s a generalizable idea for other age-related tissue losses.
• Timing and cell quality: Cells taken and frozen (banked) earlier in life are often healthier and more potent. For people considering future regenerative therapies, banking tissue or stem cells (when young and healthy) could preserve more robust cells for later autologous treatments.
• Practical implication: As regenerative medicine advances, having a private supply of cryopreserved autologous cells (e.g., muscle-derived cells, adipose-derived stem cells, cord blood) may increase options for personalized, low-risk therapies to treat age-related conditions and improve quality of life.

• Small study: This trial included only 20 patients. Larger, controlled trials are needed to confirm safety and effectiveness broadly.
• Follow-up and reproducibility: Two patients were lost to follow-up. Other related studies and longer-term data are important to confirm durability and safety.
• Not a universal cure: While promising for SUI, applying these results to other conditions requires additional research.
• Clinical oversight required: Any decision about stem cell banking or regenerative treatments should be made with qualified medical advice and realistic expectations.

• Original article: Mitterberger M, et al. Adult stem cell therapy of female stress urinary incontinence. Eur Urol. 2008;53(1):169–175. DOI: 10.1016/j.eururo.2007.07.026. PMID: 17683852
• Follow-up / larger series: Mitterberger M, et al. Autologous myoblasts and fibroblasts for female stress incontinence: a 1-year follow-up in 123 patients. BJU Int. 2007;100(5):1081–1085. PMID: 17760890
• Reviews and context: See reviews on muscle-derived stem cell therapy for SUI and the evolving state of stem cell applications in pelvic floor disorders (e.g., Neurourol Urodyn. 2007; Int J Mol Sci. 2021 review on muscle stem cells and SUI).

If you’d like, I can summarize the larger 123-patient follow-up study, explain different stem cell banking options (what to bank, how long cells remain viable), or list ongoing clinical trials in pelvic floor regenerative therapies.