Naside Mangir

Mesenchymal stem cell therapy in treatment of erectile dysfunction: Autologous or allogeneic cell sources?: MSC in treatment of ED

To compare the efficacy of intracavernosal injection of autologous and allogeneic mesenchymal stem cells as potential treatment of erectile dysfunction in an experimental rat model.

Production of ascorbic acid releasing biomaterials for pelvic floor repair

Graphical abstract

Biodegradable scaffolds designed to mimic fascia-like properties for the treatment of pelvic organ prolapse and stress urinary incontinence.

There is an urgent clinical need for better synthetic materials to be used in surgical support of the pelvic floor. The aim of the current study was to construct biodegradable synthetic scaffolds that mimic the three-dimensional architecture of human fascia, which can integrate better into host tissues both mechanically and biologically. Therefore, four different polylactic acid (PLA) scaffolds with various degrees of fibre alignment were electrospun by modifying the electrospinning parameters. Physical and mechanical properties were assessed using a BOSE electroforce tensiometer. The attachment, viability and extracellular matrix production of adipose-derived stem cells cultured on the polylactic acid scaffolds were evaluated. The bulk density of the scaffolds decreased as the proportion of aligned fibres increased. Scaffolds became stronger and stiffer with increasing amounts of aligned fibres as measured along the axis parallel to the fibre alignment. In addition, more total collagen was produced on scaffolds with aligned fibres and was organised in the direction of the aligned fibres. In conclusion, the electrospinning technique can be easily modified to develop biodegradable scaffolds with a spectrum of mechanical properties allowing extracellular matrix organisation towards human-like fascia.

Safety and Efficacy of Retropubic or Transobturator Midurethral Slings in a Randomized Cohort of Turkish Women

Objective: The aim of this study was to evaluate the safety and efficacy of retropubic (RP) or transobturator (TO) midurethral slings (MUS) in a prospective randomized cohort of Turkish women. Patients and Methods: A total of 54 women with urodynamic stress urinary incontinence (SUI) were randomized to undergo either RP or TO MUS between August 2006 and February 2013 in a tertiary referral center by a single surgeon. All patients had history, physical examination, urodynamic evaluation and quality of life assessments. The validated Turkish versions of the SEAPI, ICIQ-SF and OAB-V8 questionnaires were used. The Advantage® RP and the Obtryx® TO MUS Systems were used for all RP and TO procedures. Results: Twenty-seven patients were randomized to each group. The median follow-up was 48.5 ± 21.8 months. The median hospital stay was 24.0 ± 4.8 h and median operative time was 35.0 ± 19.9 min. The overall objective and subjective cure rates were 92.6 and 79.6%, respectively. The quality of life of all patients significantly increased after the operation compared to their preoperative status. Patients with a poorer subjective cure rate were those with mixed urinary incontinence, whose preoperative SEAPI and OAB-V8 scores were significantly higher. Conclusion: MUS surgery is highly effective and could safely be performed in a cohort of Turkish women with SUI in subspecialty centers by experienced surgeons. There is no significant difference between RP or TO applications in terms of safety and efficacy. Further studies with long-term follow-up data are required.

Demonstration of improved tissue integration and angiogenesis with an elastic, estradiol releasing polyurethane material designed for use in pelvic floor repair

Pelvic organ prolapse and stress urinary incontinence affect 40‐50% of postmenopausal women worldwide. Polypropylene meshes have been extensively used for the surgical intervention of these disorders; however, these meshes can lead to severe complications in some patients. The need for synthetic materials more suited for use in pelvic floor repair is widely accepted. This study aims to develop an electrospun 17‐β‐estradiol releasing polyurethane (PU) scaffold that not only provides the appropriate mechanical support but can also stimulate new extracellular matrix (ECM) production and angiogenesis.

Use of a simple in vitro fatigue test to assess materials used in the surgical treatment of stress urinary incontinence and pelvic organ prolapse

Stress urinary incontinence and pelvic organ prolapse are very common conditions with a proportion of patients requiring implantation of synthetic materials for a durable repair. However increasing numbers of post‐surgical complications have been reported related to the use of polypropylene meshes. One hypothesis for the adverse response is poor mechanical matching of the relatively stiff polypropylene mesh particularly as materials in the pelvic floor will need to cope with decades of distension as occurs with increase of intraabdominal pressure on coughing, laughing, or sneezing.

1005 THE FUNCTIONAL CONSEQUENCES OF ALLOGENICITY OF ADIPOSE DERIVED STEM CELLS FOR INTRACAVERNOSAL INJECTION AFTER CAVERNOUS NERVE INJURY IN RATS

INTRODUCTION AND OBJECTIVES: Intracavernous injection of adipose derived stem cell(ADSC)s can ameliorate erectile functions after cavernous nerve injury in rats. The use of preprepared allogenic stem cells are desired but no comparative studies exist. The aim of this study is to evaluate functional consequences of either allogenic or autologous use of adipose derived stem cells. METHODS: All rats underwent bilateral paratesticular fat tissue excision at the beginning of the study. ADSCs are isolated from the excised adipose tissue in Marmara University School of Medicine Urologic Research Laboratory. After 15 days of fat excision bilateral cavernous nerve injury is performed which is followed by intracavernosal injection of stem cells or stem cell lysates accordingly to each group. One month after injection Intracavernosal Pressure/ Mean Arterial Pressure(ICP/ MAP) values are calculated after intracavernosal pressure measurement. All rats are sacrificed at the end and penile tissues are taken for immunohistochemical and molecular investigation. RESULTS: A total of 36 Sprague Dawley rats were used. ADSCs isolated from the excised paratesticular fat tissue were characterized with flowcytometry and these cells were demonstrated to be CD90 and CD 44 positive; CD11b, CD 34 and CD45 negative. These stem cells were also differentiated into 2 different tissues to prove their multilineage differentiation capacity. One month after injection ICP/ MAB values in the sham group (Group 1) were significantly higher compared to PBS injection (Group 2) group, 73,1 ( 10,3) ve 47,1 ( 14,2) (Mann Whitney U test p: 0,009), respectively. Both autologous stem cell injection group (Group 5) and allogenic stem cell injection group (Group 3) showed statistically insignificant but still better results when compared to PBS injection (Group 2), 62,1 ( 12,3), 61,0 ( 10,6) and 47,1 ( 14,2) respectively. Autologous or allogenic stem cell lysate injections(Group 4 and 6) were not better than PBS injection. The nNOS staining in corpus cavernosum of rats treated with autologous or allogenic stem cells were stronger. Also nNOS expression was quantitatively better in stem cell injection groups. CONCLUSIONS: ADSC injection can be an effective treatment to regain erectile functions after cavernous nerve injury. The use of either autologous or allogenic stem cells does not change the functional results.