الفهرس 
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Abstract
ABSTRACT:
Background: Urinary incontinence is a significant health problem with considerable social and economic impact affecting over 200 million people worldwide. What further complicates the situation is that it represents a social stigma; so many women don’t seek medical evaluation, so the condition is under diagnosed & underreported. Stress urinary incontinence (SUI) is the most common type in women (especially in young women). Different treatment modalities are available for stress incontinence in women, however; they remain unable to target the fundamental mechanisms of injury or etiology of disease. Preliminary studies using stem cells aim at achieving a stronger urethral sphincter, as they have the ability to multiply & differentiate regenerating the urethral sphincter.
Aim of the study: To compare the efficacy of autologous bone marrow-derived mesenchymal stem cells (MSCs) periurethral injection to that of surgery- tension free vaginal tape (TVT) in treatment of female stress urinary incontinence.
Patients and methods: Fifty female patients with stress urinary incontinence due to intrinsic sphincter deficiency were recruited into two groups; group A including 25 patients injected with stem cells; & group B; including 25 patients, for tension-free vaginal tape operation (TVT). Patients follow up visits were conducted at 3, 6, 9, and 12months after therapy, & the following data were obtained at each visit: cough test by clinical examination, incontinence questionnaire (ICIQ- UI SF), quality of life questionnaire (I-QOL Instrument Score), & urodynamic study (ALPP & MUCP).
Results: This study showed comparable efficacy & success rates for both intervention groups; as shown by: cough test, urodynamic study, patients’ questionnaires (ICIQ-UI SF) & I-QOL score. As for the cough test; in the stem cell group; 19 (73.1%) patients had negative cough test at 12 months, which was also comparable to the TVT group; in which 25 (80.6%) patients had negative cough test at 12 months. As regards the urodynamic study; the MUCP showed more than 50% increase from the baseline at 12 months in 19 (73.1%) patients of the stem cell group, which was comparable to the TVT group; in which 25 (80.6%) patients showed more than 50% improvement at 12 months. As regards I-QOL score in the stem cell group; 19 (73.1%) patients showed more than 50% improvement at 12 months compared to the baseline, which was comparable to that of the TVT group; in which 25 (80.6%) patients showed more than 50% improvement at 12 months.
Conclusion: Stem cell therapy - as an outpatient procedure - shows a good promise as a novel safe therapy for SUI, comparable to the daycare surgery “TVT”. However, the optimum source, route & dosage of the stem cells used is yet not determined, & that requires further research.
Keywords: Stress urinary incontinence, mesenchymal stem cells, TVT.