Continence Association Leader Prof. Dr. Tufan Tarcan made valuable statements on stem cell therapy and urinary incontinence. Stating that it is very difficult to say anything about the future cure for urinary incontinence with stem cell therapy, Prof. Dr. Tufan Tarcan said, “Right now, research continues. However, in the medical field, we have not been able to apply it routinely on patients now.” said.
“The aim of stem cell therapy is to develop an organ that has lost its function in the human body or a part of it that has a specific function in the human body or in the laboratory environment by enabling the stem cells to differentiate on the desired side and thus to restore the lost organ function.” Explaining that Continence Association Leader Prof. Dr. Tufan Tarcan, “The most successful and valid example of stem cell therapy today is bone marrow transplantation. Apart from this, studies on stem cell treatments are continuing in many fields.” he said.
The subject of research for the last 30 years in functional urological diseases
Stating that stem cell therapies and organ engineering in functional urological diseases have been the subject of research for the last 30 years and it has become heavier in 3 clusters. Dr. Tufan Tarcan continued as follows: “We can list it in the form of treatment of erectile dysfunction in men, repair of the external urethral sphincter, which is composed of striated muscle that has lost its ability to hold urine, and the creation of a new bladder with tissue engineering instead of the bladder that has permanently lost its ability to store or empty.”
Mentioning that the first two factors have reached the clinical application stage, but long-term successes have not been achieved now, Continence Association Leader Prof. Dr. Tufan Tarcan said, “We accept these medical applications at the research stage now. On the other hand, the third issue, the creation of a new bladder with tissue engineering, has now remained at the stage of laboratory and animal experiments and has not passed the clinical research phase.” he said.
The urinary retention system may lose its function completely in some cases
Prof. Dr. Tufan Tarcan shared the aim of stem cell application to the urethral sphincter as follows: “In some cases, the external urethral sphincter, which is the most valuable component of the urinary retention mechanism, can weaken; it may even lose its function altogether. When the sphincter structure weakens, our patients start to leak urine when they cough, laugh, sneeze or move. This situation, which we mostly see in women with increasing age and childbearing, can also be seen in men after radical prostatectomy operations for the treatment of prostate cancer. Urinary incontinence due to sphincter weakness can sometimes be seen in underlying neurological diseases such as multiple sclerosis (MS) or spina bifida. In fact, sometimes sphincter function may be completely lost and these patients cannot accumulate any urine in their bladders; They are constantly leaking urine. Bladder pads designed and manufactured to collect urine stand out as the first remedy in this patient cluster. However, since our goal is to make the patient completely dry, we need to perform complicated surgeries in specialized centers. Therefore, restoring sphincter function with stem cell therapy creates great hope in all patient groups with tension or total urinary incontinence. A level has definitely been reached in laboratory studies and animal models on this subject. Muscle cells developed in vitro in humans were injected into the sphincter muscle. However, although this application seems to be effective in the short term, it failed in the long term and no significant benefit could be obtained in the patients. Because of this, it has not been a treatment alternative that we can present to our patients with faith. It seems that we need more research on this issue.”
The idea of a new bladder excites all urologists
Prof. Dr. Tufan Tarcan continued his words as follows: “The idea of producing a new bladder in the laboratory and transplanting it to the patient is a challenge for all urologists. Our patients who hear about these studies are also waiting. But unfortunately, basic and clinical studies on neobladder engineering have failed. I think we need a longer time to achieve success. Let me briefly summarize in which diseases the new bladder application developed with tissue engineering can break new ground Especially in cases such as spinal cord injury, spina bifida and diabetes, and sometimes in unexplained idiopathic conditions, the bladder loses its storage and excretion function. Or we have to remove the bladder due to bladder cancer. In these cases, we have to make a new bladder from the intestine and thus store its storage function. It is possible to save, but there is no bladder sensation in the new bladder made from the intestine and the bladder cannot contract and empty the urine. Therefore, with the pac intermittent catheterization formula, the patient empties his bladder by self-probing 6 times a day. This process has to be done for a lifetime. If a new bladder that provides sensation and contraction of the bladder can be created with tissue engineering, our patients will not have to empty their bladders with the intermittent catheterization system and normal urination will be possible. Unfortunately, a bladder that can feel and contract now has not been made by tissue engineering. However, research continues.”
