From bench to bedside: A narrative review of regenerative medicine approaches for postprostatectomy incontinence

Postprostatectomy urinary incontinence (PPUI) is a prevalent complication following radical prostatectomy, with long‑term incontinence affecting up to one‑third of patients. Conventional treatments are limited by inconsistent efficacy, side effects or invasiveness, indicating demand for alternative therapies. This narrative review assessed clinical evidence of regenerative therapies, especially autologous stem cell approaches, for PPUI. We searched multiple databases for studies published between 2010 and 2024; eligible articles were clinical trials using stem cell therapies for PPUI, while non‑PPUI incontinence or non‑clinical outcome studies were excluded. Eight studies enrolling 311 patients were included: six used adipose‑derived stem cells (ADSCs) and two used muscle‑derived cells, administered via periurethral, transurethral or surgical implantation. Overall, 43.7% of patients achieved continence improvement, with efficacy ranging from 0% to 100% across studies; adverse events were mostly mild and self‑limiting. However, heterogeneity in study design, small sample sizes, inconsistent outcomes and short follow‑up restricted generalizability. Regenerative cell therapies, particularly ADSCs, are promising and well‑tolerated for PPUI. ADSCs are superior in easy harvest, scalability and multilineage differentiation. Although early data are encouraging, large‑scale, long‑term studies are required to confirm efficacy, optimize delivery and evaluate long‑term safety and durability.