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VOLUME 3 , ISSUE 1 ( January-June, 2025 ) > List of Articles

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Stem Cell Therapy for Pelvic Floor Disorder: A Literature Review of Basic Science to Latest Advancements and Trial Results

Kadek Fajar Marta, Anak Agung Ngurah Jaya Kusuma, I Nyoman Mantik Astawa, I Wayan Putu Sutirta Yasa

Keywords : Conservative treatment, Muscle regeneration, Pelvic floor dysfunction, Stem cell, Stem cell growth factors, Stem cell therapy

Citation Information : Marta KF, Kusuma AA, Astawa IN, Yasa IW. Stem Cell Therapy for Pelvic Floor Disorder: A Literature Review of Basic Science to Latest Advancements and Trial Results. J Obstet Gynaecol 2025; 3 (1):32-41.

DOI: 10.5005/jogyp-11012-0036

License: CC BY-NC 4.0

Published Online: 12-02-2025

Copyright Statement:  Copyright © 2025; The Author(s).


Abstract

Background and aim: Pelvic floor dysfunction (PFD) is linked to pelvic floor muscle dysfunction, which can cause symptoms and anatomical changes. Conservative treatment is the first approach, but surgery may be required if traditional methods fail. However, surgery often results in complications. Stem cell therapies for PFD have been developed to tackle this problem. Therefore, we wanted to review recent studies on stem cell therapies for PFD. Methods: Comprehensive research was conducted in PubMed, Embase, Cochrane Library, and Google Scholar using specific search terms that included “Stem Cells” and “Pelvic Floor Dysfunction.” Only full-text publications in English or Indonesian were included in this review. Pelvic floor dysfunction refers to the changes and anatomical symptoms that arise from impaired function of the pelvic floor muscles. Review: Stem cells are cells that have unlimited or prolonged self-renewal potential. In recent years, different treatment strategies for PFD using stem cells have been studied in vivo. Since PFD can result from muscle function and integrity loss, rebuilding muscle from the cellular level presents an ideal treatment concept. At first, it was believed that transplanted cells would differentiate and bring about functional regeneration. However, current hypotheses suggest that this could be due to direct stem cell transplantation and muscle regeneration, localized agglomeration impacts, trophic effects brought about by the secretion of stem cell growth factors, or immune modulation leading to improved tissue healing. Summary: Pelvic floor dysfunction refers to the physical symptoms and changes due to a weakened pelvic floor. Scientists have studied various therapeutic techniques involving stem cells to address PFD in living organisms. Stem cells are known for their ability to renew themselves, differentiate into different cell types, secrete growth factors, and modulate the immune system.

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  1. Olsen AL, Smith VJ, Bergstrom JO, et al. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 1997;89(4):501–506. DOI: 10.1016/S0029-7844(97)00058-6.
  2. Wu JM, Hundley AF, Fulton RG, et al. Forecasting the prevalence of pelvic floor disorders in US Women: 2010 to 2050. Obstet Gynecol 2009;114(6):1278–1283. DOI: 10.1097/AOG.0b013e3181c2ce96.
  3. Quiroz LH, Gutman RE, Shippey S, et al. Abdominal sacrocolpopexy: Anatomic outcomes and complications with Pelvicol, autologous and synthetic graft materials. Am J Obstet Gynecol 2008;198(5):557.e1–557.e5575. DOI: 10.1016/j.ajog.2008.01.050.
  4. Lin M, Lu Y, Chen J. Tissue-engineered repair material for pelvic floor dysfunction. Front Bioeng Biotechnol 2022;10(2):968482. DOI: 10.3389/fbioe.2022.968482.
  5. Milani R, Frigerio M, Cola A, et al. Outcomes of transvaginal high uterosacral ligaments suspension: Over 500-patient single-center study. Female Pelvic Med Reconstr Surg 2018;24(3):203–206. DOI: 10.1097/01.spv.0000533751.41539.5b.
  6. Wright B, Emmanuel A, Athanasakos E, et al. Women's views on autologous cell-based therapy for post-obstetric incontinence. Regen Med 2016;11(2):169–180. DOI: 10.2217/rme.15.88.
  7. Faubion SS, Shuster LT, Bharucha AE. Recognition and management of nonrelaxing pelvic floor dysfunction. Mayo Clin Proc 2012;87(2): 187–193. DOI: 10.1016/j.mayocp.2011.09.004.
  8. Stangel-Wojcikiewicz K, Piwowar M, Jach R, et al. Quality of life assessment in female patients 2 and 4 years after muscle-derived cell transplants for stress urinary incontinence treatment. Ginekol Pol 2016;87(3):183–189. DOI: 10.17772/gp/61330.
  9. Carr LK, Steele D, Steele S, et al. 1-year follow-up of autologous muscle-derived stem cell injection pilot study to treat stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2018;19(6): 881–883. DOI: 10.1007/s00192-007-0553-z.
  10. Arnouk A, De E, Rehfuss A, et al. Physical, complementary, and alternative medicine in the treatment of pelvic floor disorders. Curr Urol Rep 2017;18(6):47. DOI: 10.1007/s11934-017-0694-7.
  11. Ding DC, Chang YH, Shyu WC, et al. Human umbilical cord mesenchymal stem cells: A new era for stem cell therapy. Cell Transpl 2015;24(3):339–347. DOI: 10.3727/096368915X686841.
  12. Karussis D, Karageorgiou C, Vaknin-Dembinsky A, et al. Safety and immunological effects of mesenchymal stem cell transplantation in patients with multiple sclerosis and amyotrophic lateral sclerosis. Arch Neurol 2010;67(10):1187–1194. DOI: 10.1001/archneurol.2010.248.
  13. Cruz FF, Borg ZD, Goodwin M, et al. Systemic administration of human bone marrow-derived mesenchymal stromal cell extracellular vesicles ameliorates aspergillus hyphal extract-induced allergic airway inflammation in immunocompetent mice. Stem Cells Transl Med 2015;4(11):1302–1316. DOI: 10.5966/sctm.2014-0280.
  14. Alviano F, Fossati V, Marchionni C, et al. Term Amniotic membrane is a high throughput source for multipotent Mesenchymal Stem Cells with the ability to differentiate into endothelial cells in vitro. BMC Dev Biol 2007;7(1):11. DOI: 10.1186/1471-213X-7-11.
  15. Ankrum JA, Ong JF, Karp JM. Mesenchymal stem cells: Immune evasive, not immune privileged. Nat Biotechnol 2014;32(3):252–260. DOI: 10.1038/nbt.2816.
  16. Dominici M, Le Blanc K, Mueller I, et al. Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy 206;8(4):315–317. DOI: 10.1080/14653240600855905.
  17. Lin G, Wang G, Banie L, et al. Treatment of stress urinary incontinence with adipose tissue-derived stem cells. Cytotherapy 2010;12(1):88–95. DOI: 10.3109/14653240903350265.
  18. Ben Menachem-Zidon O, Gropp M, Ben Shushan E, et al. Systemically transplanted mesenchymal stem cells induce vascular-like structure formation in a rat model of vaginal injury. PLoS One 2019;14(6):e0218081. DOI: 10.1371/journal.pone.0218081.
  19. Salcedo L, Mayorga M, Damaser M, et al. Mesenchymal stem cells can improve anal pressures after anal sphincter injury. Stem Cell Res 2013;10(1):95–102. DOI: 10.1016/j.scr.2012.10.002.
  20. Kuismanen K, Juntunen M, Narra Girish N, et al. Functional outcome of human adipose stem cell injections in rat anal sphincter acute injury model. Stem Cells Transl Med 2018;7(3):295–304. DOI: 10.1002/sctm.17-0208.
  21. Toma JG, McKenzie IA, Bagli D, et al. Isolation and characterization of multipotent skin-derived precursors from human skin. Stem Cells 2005;23(6):727–737. DOI: 10.1634/stemcells.2004-0134.
  22. Galipeau J, Sensébé L. Mesenchymal stromal cells: Clinical challenges and therapeutic opportunities. Cell Stem Cell 2018;22(6):824–833. DOI: 10.1016/j.stem.2018.05.004.
  23. DeLancey JOL. Pelvic floor anatomy and pathology. In: Hoyte L, Damaser M, eds. Biomechanics of the Female Pelvic Floor. Elsevier: London. 2019;13–51. DOI: 10.1016/B978-0-12-803228-2.00002-7.
  24. Liu X, Wang S, Wu S, et al. Exosomes secreted by adipose-derived mesenchymal stem cells regulate type I collagen metabolism in fibroblasts from women with stress urinary incontinence. Stem Cell Res Therapy 2018;9(1):59. DOI: 10.1186/s13287-018-0899-9.
  25. Ni J, Li H, Zhou Y, et al. Therapeutic potential of human adipose-derived stem cell exosomes in stress urinary incontinence–an in vitro and in vivo study. Cell Physiol Biochem 2018;48(4):1710–1722. DOI: 10.1159/000492298.
  26. Sebe P, Doucet C, Cornu JN, et al. Intrasphincteric injections of autologous muscular cells in women with refractory stress urinary incontinence: A prospective study. Int Urogynecol J 2011;22:183–189. DOI: 10.1007/s00192-010-1255-5.
  27. Majka M, Stangel-Wójcikiewicz K, Jarocha D, et al. Autologous muscle-derived cells for the treatment of female stress urinary incontinence: A 2-year follow-up of a Polish investigation. 2014;33(3):324–330. DOI: 10.1002/nau.22404.
  28. Carr LK, Robert M, Kultgen PL, et al. Autologous muscle derived cell therapy for stress urinary incontinence: A prospective, dose ranging study. J Urol 2013;189(2):595–601. DOI: 10.1016/j.juro.2012. 09.028.
  29. Peters KM, Dmochowski RR, Carr LK, et al. Autologous muscle-derived cells for treatment of stress urinary incontinence in women. J Urol 2014;192(2):469–476. DOI: 10.1016/j.juro.2014.02.047.
  30. Arjmand B, Abedi M, Arabi M, et al. Regenerative medicine for the treatment of ischemic heart disease; status and future perspectives. Front Cell Dev Biol 2021;9:704903. DOI: 10.3389/fcell.2021.704903.
  31. Frudinger A, Marksteiner R, Pfeifer J, et al. Skeletal muscle-derived cell implantation for the treatment of sphincter-related faecal incontinence. Stem Cell Res Ther 2018;9(1):233. DOI: 10.1186/s13287-018-0978-y.
  32. Sarveazad A, Newstead GL, Mirzaei R, et al. A new method for treating fecal incontinence by implanting stem cells derived from human adipose tissue: Preliminary findings of a randomized double-blind clinical trial. Stem Cell Res Ther 2017;8(1):40. DOI: 10.1186/s13287-017-0489-2.
  33. Zhang Y, Ma YD, Chen J, et al. Mesenchymal stem cell transplantation for vaginal repair in an ovariectomized rhesus macaque model. Stem Cell Res Ther 2021;12(1):406. DOI: 10.1186/s13287-021-02488-2.
  34. Zou XH, Zhi YL, Chen X, et al. Mesenchymal stem cell seeded knitted silk sling for the treatment of stress urinary incontinence. Biomaterials 2010;31(18):4872–4879. DOI: 10.1016/j.biomaterials.2010.02.056.
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