Background: Postprostatectomy urinary incontinence (PPUI) remains a prevalent complication following radical prostatectomy for the treatment of prostate cancer, with persistent incontinence affecting up to one-third of patients in the long term. Conventional treatments are often limited by inconsistent efficacy, adverse effects, or invasiveness, underscoring the need for alternative therapies. Regenerative medicine, particularly stem cell-based therapies, has emerged as a promising minimally invasive approach for the functional restoration of the urinary sphincter. Objective: This narrative review evaluates the current clinical and preclinical evidence regarding the use of regenerative therapies, specifically autologous stem cell-based approaches, for the treatment of PPUI. Methods: A literature review of studies published between 2010 and 2024 was conducted across multiple databases. Eligible studies included both clinical trials and animal models that utilized stem cell therapies for PPUI. Studies focusing on incontinence unrelated to prostatectomy or those lacking clinically oriented outcomes were excluded. Results: Eight studies (311 patients) met the inclusion criteria. Six studies used adipose-derived stem cells (ADSCs) and the remaining two used muscle-derived cells. The administration techniques varied across studies, including periurethral, transurethral, and surgical implantation. Across the studies, 43.7% of patients demonstrated improvement in continence outcomes, with individual study efficacy ranging from 0% to 100%. The adverse events were generally mild and self-limiting. Despite promising results, variability in the study design, small sample sizes, inconsistent outcome measures, and short follow-up durations limit generalizability. Conclusions: Regenerative cell therapies, particularly those using ADSCs, are promising and well-tolerated interventions for PPUI. ADSCs offer several clinical advantages over muscle-derived cells, including ease of collection, scalability, and multilineage differentiation. Although early data are encouraging, large-scale and long-term studies are needed to validate efficacy, optimize delivery protocols, and assess durability and safety. This review outlines the evolving role of regenerative medicine in advancing care and providing symptomatic relief to men with PPUI.
Haffke et al. (Tue,) studied this question.