Urodinamic study
INCONTINENCE, CONTRACTION, STERILE, LEAKAGE, COMPLICATIONS, URETHRA
The urodynamic study was divided into three phases: uroflowmetry, cystometry and flow-pressure study.Uroflowmetry is the first phase of the exam and is also called free urinary fluid. It allows us to obtain the maximum flow, mean flow and urination volume. Additionally, it provides postvoiding residue that can be measured by ultrasound or vesical catheterization.Cytometry is the second phase of the exam and is performed with vesical catheterization with two urethral tubes, an 8-French probe for bladder filling with 0.9% saline solution and a 6-French urethral probe to measure intravesical pressure during bladder filling and emptying. A catheter with a cuff was inserted into the rectal ampulla to measure intra-abdominal pressure. During bladder filling, the following data were obtained: maximum cystometric capacity, compliance, presence of urinary leakage with effort maneuvers and detrusor contraction.The flow-pressure assessment was the last phase of the urodynamic study. The patient was asked to start voiding with the urethral tubes still in place to assess detrusor pressure and maximal flow during voiding. Thus, it is possible to assess bladder emptying and conclude whether there is normal or reduced detrusor contraction [Patients diagnosed with DU who agreed to participate in the research and signed the free and informed consent form were immediately included in the study, and the tests performed during the diagnosis were used as time zero (start of the study). At that moment, the patients also answered the International Consultation on Incontinence Questionnaire-Short-Form (ICIQ-SF). T0 was considered the control situation, that is, how the patients were before any intervention. A new evaluation was performed 60 days after the end of cell therapy (T1). Twelve months (T3) after the end of cell therapy, the patients answered the ICIQ-SF questionnaire again. The ICIQ-SF is a validated and widely used international questionnaire in the area [The adipose tissue for the extraction of MSCs was collected from the inner face of the right and left thighs through liposuction of each patient. The procedures were performed by a specialist in plastic surgery on an outpatient basis. For collection, aseptic technique was performed with 4% aqueous chlorhexidine, and sterile drapes were placed. Anesthesia was then administered with 125 mL of an anesthetic solution (20% lidocaine without adrenaline, 0.9% saline and 8.4% sodium bicarbonate) to promote tissue lipodistention. Then, with the aid of a liposuction cannula (3 mm), 200 mL of solution was removed. The material was placed in a sterile flask containing phosphate buffer solution (PBS) with 1% antibiotic/antimycotic (streptomycin/penicillin/amphotericin B, Sigma®, Lot 097M4875V). The material was transported to the Center for Studies in Stem Cells, Cell Therapy and Toxicological Genetics (CeTroGen). The extraction, cultivation, expansion and characterization of cells were performed according to Pesarini [After 60 days, the cells were trypsinized, washed to exhaustion with PBS and transplanted by means of cystourethroscopy via the urethra in an outpatient setting under local anesthesia. Twenty grams of 2% lidocaine gel was used.Each patient received two transplants with 2 × 10Patients were clinically followed up during and after transplantation to check for possible complications, including laboratory tests (Additional file 