Evaluation of fat grafting technique using autologous micro-fragmented adipose tissue (Lipogems®) in female patients suffering from stress urinary incontinence

Abstract

Stress urinary incontinence (SUI) is a common occurrence in women. Although causes may be multi-factorial, the ultimate consequence of urethral sphincter weakness is urinary leakage with increase in intra-abdominal pressure. The gold standard treatment for SUI is urethral sling, for which the patient may not be a candidate, versus injection of synthetic bulking agents, which requires repeat injections over the patient’s lifetime. Autologous mesenchymal stem cells are an area of great interest within regenerative medicine to offer longer lasting effects over synthetic bulking agents. Microfragmentation of the harvested fat, to isolate the mesenchymal stem cells, is a novel technique that has shown great promise in other fields. Here, we present our preliminary data for 11 women with primary stress urinary incontinence after mid-urethral injection of autologous mesenchymal stem cells. Eight women were at least one-year post-Lipogems® injection and had an average improvement in VAS score from 9 to 4.7, and a decrease in pad count from 5.3 to 4.2. Two women had complete resolution of their SUI (VAS 0, pad count 0) at 18 and 24 months post-Lipogems® injection. Only one patient had a harvest site hematoma, and three patients had post-op urinary retention which resolved. These preliminary results are supportive of the regenerative potential of autologous mesenchymal stem cells for the treatment of stress urinary incontinence. *Correspondence to: Janice Santos Cortes, Department of Surgery, Urology, The Warren Alpert School of Medicine of Brown University, 2 Dudley Street Suite 185, Providence, RI 02906, USA, E-mail: jasmd25@gmail.com