Back in Control

Excerpted from UPMC Health Journal Magazine, July/August 2005

A promising new technique to cure urinary incontinence, developed by Drs. Michael Chancellor and Johnny Huard, is revolutionary because it uses the body's own stem cells. Dr. Huard describes how these so-called adult stem cells can be used to cure disease: "We take a muscle biopsy from the patient, isolate the stem cells in that tissue, incubate them, grow millions of them, and inject them into that same patient at a location where they can develop into the type of cell that is required to heal the body or fight illness."

Urinary incontinence can be caused by neurological conditions such as spinal cord injuries or multiple sclerosis. Contributing factors in men include an enlarged prostate gland or prostate surgery. For women, contributing factors include pregnancy or childbirth. In many instances, urinary incontinence occurs because muscles in the neck of the bladder are weak and no longer hold back urine.

"In this case, the stem cells are injected into the sphincter at the bladder neck to tighten the muscle and prevent leakage of urine," explains Dr. Huard.

Drs. Chancellor and Huard launched a clinical trial of the new therapy in the fall of 2004 in Toronto, Canada. Women participating in the trial have a pea-size piece of flesh removed from their thighs. The specimens are shipped on ice to Pittsburgh, where researchers isolate the stem cells. In three weeks, the researchers can cultivate up to 20 million cells, which are then injected into the patient's dysfunctioning sphincter muscle.

By using a patient's own stems cells to treat an illness, there is less risk that the cells will be rejected. Dr. Huard points out that a current treatment for urinary incontinence involves injections of bovine collagen to tighten the sphincter. "But that doesn't always work out, and sometimes the body rejects this treatment," he says.

As the nation's number of senior citizens increases, urinary incontinence is projected to become a more prevalent problem. For many, it will become a serious quality-of-life issue.

"The emotional side effects can be devastating and too embarrassing even to discuss with a doctor. It can paralyze people with fear, robbing them of the confidence they need to go to work or even visit the store," says Dr. Chancellor.

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