RU 05. Periurethral injection of autologous adipose - derived stem cells for the treatment of stress urinary incontinence in a rat model

Purpose: To investigate whether adipose-derived stem cells (ADSCs) are capable of improving the urinary voiding function and restoring pathologic changes in a parturition-Induced stress incontinent rat model and to clarify the mechanism, by which ADSCs exert their beneficial effects by VEGF paracrine.

Materials and Methods: Rats were induced to develop stress urinary incontinence (SUI) by postpartum vaginal balloon dilation and bilateral ovariectomy. ADSCs were isolated from the periovary fat and labeled with thymidine analog 5-ethynyl- 2-deoxyuridine (EdU). Twenty rats received urethral injection of phosphate-buffered saline (PBS). Twenty rats received urethral injection of EdU-labeled ADSCs. Four weeks later, the urinary voiding function was assessed by cystometry. Histological examination (Masson's trichrome stain, picrosirius red stain, Hart's elastin stain, Gordon & Sweet's stain and immunohistochemical stain) and western blot were performed.

Results: Cystometric analysis showed that ADSCs treatment resulted in significant recovery of urinary voiding function, as compared with SUI group. Histological analysis showed that ADSCs are capable of restoring the fibrous-muscular system in the urethra. There was more periurethral blood vessels in the ADSCs treated group compared with SUI group. The expressions of VEGF and P-ERK1/2 protein were higher in ADSCs treated group also.

Conclusions: ADSCs are capable of restoring the urethra fibrous-muscular system. VEGF paracrine and activation of ERK1/2 by ADSCs might play an important role in restoring pathologic changes of SUI.