- Deutsche Forschergemeinschaft (DFG)
- Deutsche Forschungsgemeinschaft (DFG)
Urinary incontinence, defined as frequent unwanted loss of urine, leads even to a small extent to social problems, but with larger quantities also to health problems. The costs incurred in Germany for incontinence remedies alone exceed half a billion euros annually. For the most frequent cause of urinary incontinence, stress incontinence (SUI), usually caused by a weakness or malfunction of the urethral sphincter, there has been no sustained curative treatment to date. The Clinical Research Group (KFO) is investigating various aspects of a possible curative, cell-based therapy to strengthen the weakened urethral sphincter.
Urinary incontinence corresponds to the objectifiable involuntary loss of urine, which is a major and complex problem that affects the quality of life, hygiene, health (acute and chronic urinary tract infections, including permanent organ damage) and social connection of the affected patients themselves, but can also put a strain on their environment. In Germany alone, about six to eight million women and men suffer from incontinence. The most common form of urinary incontinence is stress or stress incontinence (SUI), the main cause of which is usually a weakening or malfunction of the sphincter muscles. A sustainable curative treatment of sphincter-induced stress incontinence does not yet exist for the majority of patients.
The increase in SUI at an advanced age correlates directly with the spontaneous apoptosis rate of the muscle cells in the bladder sphincter. Muscle injuries can also contribute to an increased risk of incontinence in old age. Other risk factors include body weight, pelvic floor surgery, pregnancy and vaginal birth, and perimenopausal life. Anatomical and functional studies confirmed that both the striated external urethral sphincter and the three-layer smooth musculature of the urethra constitute the continence mechanism. Functional limitations of the rhabdosphincter or loss of tone of the smooth muscle urethra are mainly responsible for the development of SUI. Under favourable circumstances, the loss of functional muscle cells in the sphincter uretrae externus muscle can be temporarily compensated by improving the function of the remaining cells. A cell-based therapy to strengthen the sphincter muscle, which is weakened for various reasons, as well as a possible improvement of the innervation are therefore promising therapy concepts which attack the real cause of the problem.
Three clinical core questions are in the focus: 1.) Can cells or implants be applied precisely and intraoperatively to the urethral sphincter? 2.) Do the applied cells integrate physiologically into the muscle and are they connected to the nerve control mechanism? 3. 3.) Do the applied cells remain vital in the injection area, and what regenerative role do they play over time?
- Dr. S. DiGiovanni, Hertie Institut für Klinische Hirnfoschung
- Prof. Dr. ing. O. Sawodny, Institut für Systemdynamik, Universtität Stuttgart
- Prof. Dr. med. A. Stenzl, Urologische Klinik Tübingen
- Prof. Dr. med. K.D. Sievert, Urologische Klinik Tübingen
- Prof. Dr. rer. nat. B. Pilcher, Abt. Präklinische Bildgebung und Radiopharmazie, Radiologische Klinik Tübingen
- Prof. Dr. rer. nat. E. Guenther, Naturwissenschaftliches Medizinisches Institut an der Universtität Tübingen
- Prof. Dr. rer. nat. W. Aicher, Urologie Tübingen und Zentrum für Regenerative Medizin (ZRM)