KFO 273: Therapy of Urinary Incontinence by Cell-based Regeneration of the Sphincter Muscle of the Urethra

尿失禁被定义为经常不由自主地排尿。轻微的大小便失禁会导致社会问题，而严重的大小便失禁会导致严重的健康问题。在德国，每年用于治疗尿失禁的辅助设备的成本超过5亿欧元。对于最常见的尿失禁原因，压力性尿失禁(SUI)，到目前为止还没有持续的治疗方法。隋症是由尿道括约肌无力或功能障碍引起的。临床研究单位将探索一种可能的治愈的、基于细胞的疗法的各个方面，以加强被削弱的尿路括约肌。我们主要关注三个临床问题：(1)细胞或植入物能否准确地应用于尿道括约肌，这一过程能否在术中控制？(2)应用的细胞是否在肌肉中进行生理性整合，它们是否与神经控制系统相连？(3)应用的细胞在注射后是否保持活力，以及它们的再生潜力是什么？在临床研究股内的五个相互作用的项目和两个横断面项目中，将实施下列研究方案：(A)选择和准备适合于退化或受损的括约肌再生的细胞，(B)开发温和但精确的细胞外科方法和应用技术，(C)开发用于导航应用设备的精确成像方法，(D)开发注射后细胞的检测技术和临床前模型的中期随访方法，(E)开发用于尿动力学测量和肌肉力量测量的改进的、更灵敏的传感器。

Urinary incontinence is defined as frequent involuntary loss of urine. Mild forms of incontinence lead to social problems, while more severe forms result in serious health problems. In Germany costs for auxiliary devices to cope with urinary incontinence exceed half a billion euros annually. For the most common cause of urinary incontinence, stress incontinence (SUI), there is no sustainable curative treatment so far. SUI is caused by a weakness or malfunction of the urethral sphincter. The Clinical Research Unit will explore various aspects of a possible curative, cell-based therapy to strengthen the weakened urethral sphincter. We focus on three main clinical questions: (1) Can cells or implants be accurately administered in the urethral sphincter and can this process be controlled intraoperatively? (2) Do the applied cells integrate physiologically in the muscle and do they connect to the neuronal control systems? (3) Do the applied cells remain vital after injection and what is their regenerative potential in time? In five interacting projects and two cross-sectional projects within the Clinical Research Unit the following research programme will be implemented: (A) The selection and preparation of cells suitable for regeneration of a degenerated or damaged sphincter muscle, (B) The development of gentle but precise surgical methods and application technologies for cells, (C) The development of an accurate imaging method for the navigation of the application equipment, (D) The development of techniques for the detection of cells after their injection and methods for medium-term follow-up in a pre-clinical model, (E) The development of improved and more sensitive sensors for urodynamic measurements and for measuring muscle strength.