Stem cell injection successfully treats urinary incontinence

It started when Deborah Bishop was still in her 20s.

Always athletic -- she had participated in field hockey, speed skating and baseball -- Ms. Bishop was doing jumping jacks when she noticed to her embarrassment that she had leaked urine.

As the weeks wore on, the Canadian woman began to have more and more of these accidents. It wasn't just strenuous exercise that caused them, but also being tickled or coughing or sneezing.

The condition is known as stress urinary incontinence, and researchers say it may affect hundreds of millions of people around the world, primarily women, who are more susceptible because of their anatomy.

Today, Ms. Bishop, 54, is "90 percent" normal on her urinary leakage, she said -- all because of an injection of her own stem cells that she received three years ago.

The cells, known officially as autologous muscle-derived cells, were taken out of her thigh, multiplied several times over in the lab, and then injected into the muscles around her urethra, the opening at the neck of the bladder.

While many people still associate the phrase "stem cells" with ethical debates over using embryos, these stem cells have nothing to do with that.

All of us have stem cells in various parts of our bodies that can develop into mature cells and are used to repair muscle, nerve and tissue damage.

In this case, researcher Johnny Huard at the University of Pittsburgh developed a technique for finding stem cells in muscle tissue and then purifying and multiplying them. The biomedical firm Cook MyoSite Inc. bought the licensing rights to his technique and is overseeing the current tests on treating stress urinary incontinence.

The idea is that the stem cells will create new cells that will strengthen the muscles that control urination. Even though the initial trials were focused on testing the safety of the procedure, 60 to 70 percent of the women have shown a significant decrease in their urinary leakage, said Ryan Pruchnic, Cook MyoSite's director of operations.

Lesley Carr, Ms. Bishop's physician and a urologist at Sunnybrook Health Sciences Centre in Toronto, said there is no medication that helps with this most prevalent form of incontinence. Up to now, the primary last-resort therapy has been surgical insertion of a mesh sling around the urethra.

The surgery is effective, Dr. Carr said, but "there are rare but recognized complications," including pain and infections, and women face up to six weeks of restricted activity after the operation.

That was a big obstacle for Ms. Bishop, not only because she is so physically active, but because she was in the middle of a house renovation when she sought help for her condition.

"I told Dr. Carr I couldn't afford to be out of commission for six weeks," she recalled, "and that's when she must have mentioned the stem cell trial to me."

In July 2009, she had a piece of her outer thigh muscle removed under local anesthesia, a procedure she admits left her feeling "like I'd been kicked by a horse" for about a week.

Researchers then located and multiplied the stem cells in her muscle tissue, and the following September, she had them injected into the muscles around her urethra. The entire injection took about five minutes, she said, and she felt nothing.

The improvement was gradual after that. "I noticed a difference in a couple months," she said, "and a significant difference in four or five months. I thought what made it really unique was that it was using my own muscle cells."

The procedure means that today, she can do her strenuous morning exercises of standing broad jumps and stride jumps without having to wear heavy pads to absorb leakage.

The latest trials with the stem cells are the first to enroll women who will either get real stem cells or placebo injections. Cook MyoSite hopes to have solid results and be able to bring the procedure to market by 2015, Mr. Pruchnic said.

The company has also begun initial tests of the muscle stem cells in people who have had heart attacks or are experiencing chronic heart failure, in hopes they will restore the strength and flexibility of cardiac muscle.

By using a person's own cells, Dr. Carr noted, there is no need for patients to take immunosuppressive medications. She believes such regenerative medicine "will be the wave of the future in most fields" of health care.

Ms. Bishop is certainly sold.

"I've got a girlfriend who's had three children and is very physically active, and she's struggling with stress incontinence now, and so I'm an advocate for this.

"It was an excellent experience for me, and I would highly recommend it to anyone."

Mark Roth: mroth@post-gazette.com or 412-263-1130.

First published on February 13, 2012 at 12:00 am

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Stem cell injection successfully treats urinary incontinence

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