Reconstitution of urethral sphincter and neurovascular bundle using skeletal muscle-derived multipotent stem cells.

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Postoperative damage of the urethral rhabdosphincter (URS) and neurovascular bundle (NVB) is a major operative complication of radical prostatectomy. It is generally recognized to be caused by unavoidable surgical damage to the muscle-nerve-blood vessel units around the urethra. We have identified two stem cell populations in the skeletal muscle that are able to reconstitute the muscle-nerve-blood vessel unit. Thus, we tried to reconstitute post-operative damage of urethral sphincter and NVB using these stem cells. Results showed that transplanted cells differentiated into skeletal muscle fibers, peripheral nerve (Schwann cells, perineurium) and blood vessel (endothelial cells, pericyte) relating cells and facilitated the reconstitution of the muscle-nerve-blood vessel units around the urethra. Supporting these data, significant functional recovery (P<0.05) of urethral sphincter and NBV unit, which was evaluated as urethral pressure profile (UPP) via electrical stimulation, was observed in the cell-transplanted group compared to control group. These findings indicated that transplantation and/or teatment of skeletal muscle-derived stem cells is a useful tool for the reconstitution of reduced urethral function after radical prostatectomy.