An animal experimental study on pubourethral ligament restoration with platelet rich plasma for the treatment of stress urinary incontinence

Abstract

Introduction Minimally invasive methods for injured ligament and tendon restoration have been developed and gained popularity in recent years. Injury and relaxation of the pubourethral ligament (PUL) can lead to stress urinary incontinence (SUI). The aim of this study was to investigate the impact of injecting platelet rich plasma (PRP) into the PUL following its surgical transection resulting in SUI, confirmed by leak point pressure (LPP) measurements pre- and post-intervention in an experimental animal model. Material and methods Twenty female adult Sprague-Dawley rats were assigned in 2 groups: 1) treatment group with transection of the PUL and application of PRP at the time of transection and at one month follow-up and 2) a control group, with transection of the PUL only. Leak point pressures (LPPs) were measured prior to transection, immediately following the transection and at 1 and 2 months in both groups. Results The median LPPs for the control group were: LPP – preT: 35.6 (29.8–44.8) cmH2O, LPP – postT: 14.6 (5.8–19.0) cmH2O, LPP – 1 month: 27.3 (19.2–33.8) cmH2O, LPP – 2 months: 29.0 (27.0–34.0) cmH2O, whereas for the PRP group were: LPP-preT: 40.5 (33.2–46.3) cmH2O, LPP – postT: 15.7 (3.0–24.0) cmH2O, LPP – 1month: 31.6 (24.8–37.4) cmH2O, LPP – 2 months: 36.8 (32.5–45.4) cmH2O. PRP injections on transected PULs significantly increased LPPs at one month follow-up [31.6 cmH2O vs. 27.3 cmH2O, p = .043]. This effect was confirmed at two months [36.8 cmH2O vs. 29.0 cmH2O, p <.001]. Conclusions Injection of PRP into transected PULs significantly improved LPPs at one and two months' follow-up. However, further experimental and clinical research is needed to evaluate the safety and efficacy of this treatment, in clinical practice.