Abstract
Zusammenfassung. Urininkontinenz betrifft eine Vielzahl an Patientinnen und Patienten, und die Kosten für die Behandlung nehmen mit der demografischen Entwicklung weiter zu. Es gibt verschiedene konservative und chirurgische Therapieansätze, die in ihrer Wirkung meistens limitiert oder zeitlich begrenzt sind. Langfristige und nachhaltige Lösungsansätze sind gesucht, wobei die Behandlung mittels regenativer Therapien unter Verwendung von Stammzellen eine vielversprechende Alternative darstellt. Verschiedene präklinische und klinische Studien haben den Einsatz von Vorläuferzellen zur Stärkung des Blasenschliessmuskels untersucht. Dieser Review diskutiert die Thematik der Belastungsinkontinenz von der Physiologie über die herkömmliche Behandlung bis hin zu neuartigen Therapieformen unter Verwendung von Muskelstammzellen. Zudem informieren die Autoren über eine laufende prospektive Studie am Universitätsspital Zürich, die sich der modernen regenerativen Therapieform bedient.
Abstract. Urinary incontinence affects a large number of patients, and the cost of treatment continues to rise with the demographic change. There are various conservative and surgical therapies, which are often limited in their effect or limited in time. We are lacking long-term and sustainable solutions, whereas the treatment with a regenerative approach using stem cells forms a promising alternative. Various preclinical and clinical studies have investigated the use of precursor cells to strengthen the urinary sphincter muscle. This review discusses the issue of stress incontinence from the physiological point of view to conventional treatment and novel therapies using muscle stem cells. In addition, the authors inform about an ongoing prospective trial at the University Hospital in Zurich, which makes use of this modern and regenerative therapy form.
Résumé. L’incontinence urinaire touche un grand nombre de patients et le coût du traitement continue d’augmenter avec l’évolution démographique. Il existe diverses approches thérapeutiques (conservatives et chirurgicales), dont l’effet est généralement limité à long terme. Des solutions durables et persistantes sont recherchées, le traitement par des thérapies régénératives utilisant des cellules souches étant une alternative prometteuse. Diverses études précliniques et cliniques ont étudié l’utilisation de cellules précurseurs pour renforcer le sphincter de la vessie. Cet article traite de l’incontinence à l’effort, de la physiologie au traitement conventionnel, en passant par les nouvelles thérapies utilisant des cellules souches musculaires. En outre, les auteurs décrivent sur une étude prospective en cours à l’Hôpital universitaire de Zurich, utilisant une forme moderne et régénérative.
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