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Safety, efficacy and health related quality of life of autologous myoblast transplantation for treatment of urinary incontinence in children with bladder exstrophy-epispadias complex.

AbstractPURPOSE:
Children with bladder exstrophy-epispadias complex undergoing endourethral autologous myoblast transplantation to treat urinary incontinence were evaluated at 4 years of followup regarding the safety, efficacy and durability of the procedure, and health related quality of life.
MATERIALS AND METHODS:
Seven boys underwent autologous myoblast transplantation between May and December 2006. All patients had persistent urinary incontinence after bladder neck reconstruction and bulking agent injection. Patients were followed for 4 years after autologous myoblast transplantation regarding clinical outcomes and cystometric, urodynamic, uroflowmetric and urethrocystoscopic evaluations. Health related quality of life was also measured before treatment and at final followup.
RESULTS:
No evidence of urinary obstruction was observed. Five children (71%) were completely continent and 2 (29%) were socially dry with complete daytime dryness at final followup. Health related quality of life was improved significantly. Urodynamic studies revealed a progressive increase in bladder capacity (p <0.001). Mean detrusor leak point pressure showed a 27 cm H(2)O (158%) increase during 4-year followup. Uroflowmetry parameters of voided volume and average maximum flow rate were improved significantly (p <0.001).
CONCLUSIONS:
The 4-year outcomes demonstrate that autologous myoblast transplantation for urinary incontinence in children with bladder exstrophy-epispadias complex is relatively reliable, reproducible, safe and effective with minimal morbidity. This novel treatment represents a promising therapeutic approach in patients with urinary incontinence. Further randomized trials with larger numbers of patients and longer followup are needed.
AuthorsAzadeh Elmi, Abdol-Mohammad Kajbafzadeh, Ali Tourchi, Saman Shafaat Talab, Shadi Abdar Esfahani
JournalThe Journal of urology (J Urol) Vol. 186 Issue 5 Pg. 2021-6 (Nov 2011) ISSN: 1527-3792 [Electronic] United States
PMID21944110 (Publication Type: Journal Article)
CopyrightCopyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Topics
  • Bladder Exstrophy (complications, surgery)
  • Child
  • Epispadias (complications, surgery)
  • Female
  • Humans
  • Male
  • Myoblasts (transplantation)
  • Quality of Life
  • Surveys and Questionnaires
  • Transplantation, Autologous
  • Treatment Outcome
  • Urinary Bladder (surgery)
  • Urinary Incontinence (complications, surgery)
  • Urodynamics

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