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The Outcome of Cell Therapy Treating Urinary Incontinence Correlates with Precise Cell Localization in the Sphincter

Niklas Harland¹, Liv Johnen¹, Kamal T Avula¹

¹Center for Medical Research, University of Tuebingen Hospital, 72072 Tuebingen, Germany.

|April 29, 2025

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Cell therapy for urinary incontinence shows promise, but success hinges on cell type and precise injection site. This study in pigs highlights optimal placement for myogenic progenitor cells and adipose-derived stromal cells for better outcomes.

Area of Science:

Regenerative Medicine
Urology
Cell Biology

Background:

Urethral sphincter muscle deficiency causes stress urinary incontinence.
Cell therapy offers potential but often yields insufficient efficacy.
Investigating cell localization's impact on therapeutic outcomes is crucial.

Purpose of the Study:

To determine if the injection site of regenerative cells in urethral sphincter muscle correlates with treatment success in a large animal model of incontinence.
To compare the efficacy of myogenic progenitor cells (MPCs) and adipose-derived stromal cells (ADSCs) based on their localization.

Main Methods:

Urethral sphincter insufficiency was induced in pigs and confirmed via urodynamics.
MPCs or ADSCs were injected into the sphincter complex or adjacent tissues using a cystoscope-guided technique.

Keywords:

adipose tissue-derived stromal cell cell injection cell therapy large animal model of incontinence muscle regeneration myogenic progenitor cell stress urinary incontinence

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Functional recovery was assessed by urodynamics, and cell localization was confirmed by histology.

Main Results:

MPCs injected near the sphincter muscle showed better functional recovery than those in adjacent areas.
ADSCs injected into submucosal tissue adjacent to the muscle demonstrated superior regeneration compared to muscle injections.
ADSC injections achieved statistically significant improvement in incontinence after 5 weeks, while MPCs showed a robust but not significant improvement.

Conclusions:

The efficacy of cell therapy for urinary incontinence is influenced by both the type of therapeutic cell used and its precise anatomical placement.
This study provides initial evidence for optimizing cell delivery strategies in regenerative medicine for incontinence.
Precise localization is a key factor for successful cell-based treatments for stress urinary incontinence.