Adipose-derived stem cell exosomes for stress urinary incontinence: a novel in vivo therapeutic approach.

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

This study aimed to evaluate the therapeutic effects of adipose tissue-derived stem cell exosomes (ADSCE) in the management of stress urinary incontinence (SUI) using vaginal dilatation-induced acute and chronic SUI models in Sprague-Dawley rats. The model for acute and chronic SUI was established via single and repeated vaginal dilatation, respectively. Mesenchymal cells, mesenchymal stem cells, and exosomes were isolated. Flow cytometry confirmed the mesenchymal identity of isolated stem cells, while exosomal markers (CD9, CD63, CD81) validated successful exosome isolation. Transmission electron microscopy revealed the characteristic nanoscale morphology of exosomes, further supported by energy-dispersive X-ray analysis. Rats were treated with the exosomes locally and vaginally. Therapeutic efficacy was assessed through urodynamic and histopathological analyses. Abdominal leak point pressure (ALPP) was significantly reduced in both acute and chronic SUI models compared to controls (P < 0.0001). ADSCE therapy significantly increased ALPP, with systemic administration demonstrating superior efficacy over local treatment (P < 0.05). Histopathological examination indicated substantial sphincter muscle thinning, edema, and fibrosis in untreated models, while exosome therapy mitigated these pathological changes. Masson's Trichrome staining revealed significant preservation of ureth

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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