Treatment of urinary incontinence with stem cells and stem cell secretome
Urinary incontinence is the unintentional loss of urine. Stress incontinence happens when physical movement or activity — such as coughing, laughing, sneezing, running or heavy lifting — puts pressure (stress) on your bladder, causing you to leak urine.
In women pregnancy, childbirth, obesity, and menopause are the most common causes of stress incontinence, resulting from inadequate closure of the urethral sphincter due to weakness of the pelvic floor or direkt damage of the sphincter II,III,IV.
In men stress incontinence is most common after prostate surgeryI, such as prostatectomy for cancer, or TURP - transurethral resection of the prostate - for benign enlargement of the prostate, BPH benign prostatic hypertrophy.
Standard therapies of urinary incontinence often provide only symptomatic relief without targeting the underlying etiology of disease.
Recently, the use of stem cells to halt disease progression and reverse underlying pathology has emerged as a promising method to restore normal voiding function.
How do we treat? Individual Treatment Concepts
All treatment concepts at ANOVA are individually tailored to you as a patient. We take into account your medical history, your preferences, and the specific course of your illness. Depending on the type and severity of the defect, as well as the acute or chronic cause, we develop an optimal treatment plan for you. This may include a one-time treatment, multiple stem cell treatments, and other therapy forms. The following therapies are applied in cases of incontinence:
Stem Cell Therapies for Incontinence
ANOVA Institute for Regenerative Medicine - Offenbach, Germany
Potency Hypothesis of Stem Cell Therapies
Stem cells have the potential to communicate with the immune cells that cause inflammation and can, in a natural and not yet fully understood way, inhibit an immune overreaction. Additionally, stem cells have the ability to stimulate tissue regeneration, counteracting functional loss.
In recent years, there has been a particular enthusiasm for stem cell-based therapies, especially in the urological field, for treating incontinence. Several preclinical studies have explored the use of stem cells for urological diseases, particularly bone marrow stem cells (BMSC) and adipose-derived stem cells (ADSC), for the treatment of incontinence in animal models, as summarized by Soebadi et al. 2016.
In acute incontinence, it is assumed that the repair mechanism induced by stem cells occurs at a paracrine level. However, in chronic incontinence, the effect of stem cells may primarily be based on engraftment and cellular differentiation. The precise mechanism by which stem cells improve function in chronic incontinence is not yet fully understood.
MSEC - Mesenchymal Stem Cell Secretomes - Exosomes - Autologous
Patients with a long history of incontinence symptoms are typically treated with MSEC (Secretomes, Exosomes, EVs) from mesenchymal stem cells (MSC, AD-MSC, adipose-derived stem cells). These are extracted from the patients' abdomen during a mini liposuction (very short and limited fat removal) under light sedation. ANOVA is the first stem cell clinic worldwide to have obtained legal approval from the relevant state authorities, offering high-quality, safe, and legally controlled autologous (own) secretomes containing exosomes.
The main advantage of MSEC is that, unlike living stem cells that would lose their therapeutic potency, exosomes can be frozen without losing their efficacy. This allows us to produce 10-20 injection doses from a single fat removal, which can then be administered over an extended treatment period. This is particularly beneficial for long-term stimulation of regeneration in incontinence.
What a Secretome/Exosome is and how they compare is explained on our overview page.
BMC - Bone Marrow Stem Cells
Typically, BMC is our therapy of choice for urinary incontinence problems with various causes. Since this often involves a disease confined to a specific area, we treat at or near the affected site. BMC contains a natural mixture of so-called autologous (body's own) stem cells. These are extracted in a quick and uncomplicated bone marrow puncture from your pelvic bone.
These stem cells are intended to quickly contain inflammation, alleviate your symptoms, and promote regeneration. For multiple treatments, we often combine BMC administrations with PRP or hyaluronic acid (see below). Learn more about this type of stem cells here: BMC. For further information about our stem cell-based treatments for urinary incontinence, contact us anytime.
Our stem cell treatments are experimental, but we only treat patients for whom we believe the risk/benefit ratio indicates treatment based on the state of the art, i.e., medical, scientific evidence.
ANOVA - First in Stem Cell Therapy of Urinary Incontinence
At ANOVA Institute for Regenerative Medicine our interdiscipinary team of medical experts asseses your problems with incontinence and your eligibility for stem cell treatment with a comprehensive diagnostic work-up.
Together with the Prof. Stehling Institute for Imaging Diagnostics we have developed specific imaging methods to visualise the critical anatomical structures at the pelvic floor including dynamic imaging of the pelvic floor under strain and high-resolution imaging of the urinary spincter.
This allows us to direct the treatment with stem cell products precisely to the area where the stem cell are most needed. With stem cell secretome we can perfuse the urinary spincter to reactivate its function witout any damage to the delicate anatomical structure of the sphincter. This is one of the many advantages over surgical approaches, which invariably lead to a distruction of part or all of the urinary sphincter.
How Stem Cells and Their Secretome can Treat Urinary Incontinence
Stem cells are classically thought to repair damaged tissues and organs by differentiating into and replacing damaged cells. In most cases, however, stem cells exert their therapeutic effect by the secretion of bioactive molecules and microvesicles, collectively called the "stem cell secretome". It is the secretome that directs other stem and progenitor cells, which are already present in the tissue or organ, to the area of injury. The secretome also has anti-apoptotic and anti-inflammatory properties, reduces scarring, effects neo-vascularization, and has immunomodulatory properties.
Local injections of mesenchymal, muscle-derived, and adipose-derived stem cells have all yielded successful outcomes in animal models of mechanical, nerve, or external urethral sphincter injury in stress urinary incontinence. Early clinical trials using stem cells for the treatment of stress urinary incontinence in both male and female patients have yielded promising functional results with minimal adverse effectsV.
Long Awaited - Now Available for Treatment of Urinary Incontinence: ANOVA Stem Cells and Stem Cell Secretome
Whilst stem cell therapies have for many years been described as promising and successful for the treatment of urinary incontinence in the urological literature, urologists have lamented the unavailability of stem cell products due to regulatory issues. In Germany, this issue was recently addressed during the 73rd annual meeting of the German Urological Society (DGU - Deutsche Gesellschaft für Urologie) VI,VII
This has changed since ANOVA Institute for Regenerative Medicine has obtained the first production permit* for mesenchymal stem cell secretome and bone marrow stem cells.
If you suffer from urinary incontinence, call us to arrange an appointment with one of our medical specialists to find out whether stem cells can help you regain a better life.
*Approval according to § 20b und 20c, Regierungspräsidium Darmstadt and Paul Ehrlich Institute Stem cell therapy is an experimental form of therapy. Most stem cell therapies worldwide are currently not approved, as the approval process for a new form of therapy is usually a lengthy process, which in the case of stem cells has not yet been completed. Therefore, the legal application is limited to medical clinics with legal permits. Since 2018, ANOVA has had all the required legal permits for its products and is regularly inspected by the authorities to ensure safe products.
- Nitti, Victor W (2001). "The Prevalence of Urinary Incontinence". Reviews in Urology. 3 (Suppl 1): S2–S6. ISSN 1523-6161. PMC 1476070. PMID 16985992.
- Subak, Leslee L.; Richter, Holly E.; Hunskaar, Steinar (December 2009). "Obesity and urinary incontinence: epidemiology and clinical research update". The Journal of Urology. 182 (6 Suppl): S2–7. doi:10.1016/j.juro.2009.08.071. ISSN 1527-3792. PMC 2866035. PMID 19846133.
- Rortveit, G.; Hannestad, Y. S.; Daltveit, A. K.; Hunskaar, S. (December 2001). "Age- and type-dependent effects of parity on urinary incontinence: the Norwegian EPINCONT study". Obstetrics and Gynecology. 98 (6): 1004–1010. doi:10.1016/s0029-7844(01)01566-6. ISSN 0029-7844. PMID 11755545. S2CID 20932466.
- Lukacz, Emily S.; Lawrence, Jean M.; Contreras, Richard; Nager, Charles W.; Luber, Karl M. (June 2006). "Parity, mode of delivery, and pelvic floor disorders". Obstetrics and Gynecology. 107 (6): 1253–1260. doi:10.1097/01.AOG.0000218096.54169.34. ISSN 0029-7844. PMID 16738149. S2CID 1399950.
- Amend B, Stenzl A. Aktuelle Therapiemöglichkeiten für die komplizierte Belastungsharninkonntinenz bei Frauen. Uroforum 2021;9:32-34.
- Klein G, Hart ML, Brichmann A, et al. Mesenchymal stromal cells for sphincter regeneration. Adv Drug Deliv Rev. 2015;82-83:123-136